Nursing interventions:
Rheumatoid Arthritis
1. Activity intolerance related to pain and
Signs/symptoms
Holman, H. C., Williams, D., Johnson, J., Ball, B. Tender, warm, swollen joints
swelling of Joints: Pain at rest and w/movement
S., Wheless, L., Leehy, P., & Lemon, T.
Have the patient perform self-care activities. Xerostomia
(2019). Rn adult medical surgical
Begin slowly and increase daily, as tolerated. Anorexia
nursing: Review module unit 13
These activities help the patient regain health. IMMUNE SYSTEM AND CONNECTIVE Fatigue
Teach the patient how to use adaptive aids for TISSUE DISORDERS. In RN adult Paresthesia
mobility so that he or she can do as much as medical surgical nursing: Review Joint swelling and deformity
possible for self. module. Leawood, KS: Assessment Fever
Perform active or passive ROM exercises to all Technologies Institute. Muscle weakness
extremities every 2 to 4 hours to foster muscle Joint stiffening that usually worsens in the
strength and tone, maintain joint mobility, and morning
Callahan, B. (2019). Nursing: A concept-based
prevent contractures. approach to learning (Third ed Vol Subcutaneous nodules
Provide emotional support and encouragement Pathophysiology CHD, vasculitis, pleural effusion, pericarditis
to help improve patient self-esteem and provide
Rheumatoid arthritis is a chronic, progressive inflammatory
the motivation to perform ADLs.
disease that can affect tissues and organs but principally
2. Chronic pain related to the inflammation
attacks the joints, producing inflammatory synovitis. RA is an
of Joints: autoimmune disease that is precipitated by WBCs attacking
Monitor the pain level and duration of morning
synovial tissue. The WBCs cause the synovial tissue to Labs
stiffness. Pain and morning stiffness are
become inflamed and thickened. It involves joints bilaterally,
indicators of disease activity. Anti-CCP antibodies
and symmetrically, and typically affects several joints at one
Increased pain may necessitate changes in the Rheumatoid factor antibody
time. RA typically affects upper joints first.
therapeutic treatment plan. Erythrocyte sedimentation (ESR)
RA is also a systemic disease that can affect any connective
Encourage the patient to relate pain to activity C- Reactive protein
tissue in the body. Common structures affected are the blood
level and adjust their activities accordingly. Antinuclear antibody
Turn and reposition the patient every 2 hours to vessels and pleura surrounding the lungs, and pericardium.
The natural course of the disease is one of exacerbations Elevated WBCs
prevent skin breakdown and improve breathing.
3. Disturbed body imagine related to and remissions. If diagnosed and treated early, it is possible
to avoid permanent damage.
arthritic joints:
Provide emotional support and encouragement
Alternative/social Interventions
to help improve the patient's self-esteem and
provide motivation. Refer the client to support groups as
Refer the patient to self-help groups, support appropriate
groups, and other agencies that provide
assistive devices and literature. Refer the client to occupational
therapy for adaptive devices that can
Medications facilitate carrying out ADL’s and
Education prevent deformities
Instruct client to apply heat or cold to the
affected areas as indicated based on morning
NSAIDs
COX-2 enzyme blockers A home health aide can be necessary
stiffness, pain in hands/fingers, and edema. for assistance.
Encourage patients on spacing out activities Corticosteroids
to conserve energy, take rest periods, and ask Immunosuppressant/ Cytotoxic Risk factors:
for additional assistance when needed. (DMARDs)
Support client to express feelings regarding Female sex (3 for every 1 male)
effect of the disease on body image and self-
Sulfasalazine
esteem. Antimalarials
Age 30-60 years
Educate patient on the importance on the TNF inhibitors
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