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Rheumatoid Arthritis Interventions (Picmonic)
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Hey guys, let's take a look at the care plan for rheumatoid arthritis, also known as RA. In this lesson, we'll briefly take a look at the pathophysiology and etiology of RA. We're also going to look at additional things like subjective and objective data included in the care plan, as well as nursing interventions and rationales.
RA is an auto-immune disease where the immune system mistakenly targets and attacks the joint linings causing uncontrolled inflammation of the synovium. Bilateral joints are affected, primarily the wrists, the hands, and also the knees. RA is characterized by bone erosion and joint deformity, so as the disease progresses, other joints may be affected symmetrically. Chronic inflammation and degenerative changes are the hallmark aspects of RA. Doctors are unsure of what triggers RA, but it appears to be partially genetic. The genetic predisposition makes the patient more susceptible to environmental factors like viruses and bacteria that may trigger the initial inflammation. Once the inflammation begins, the synovial fluid thickens and the tendons and ligaments stretch, resulting in the joint losing its shape and alignment. While there is no cure for RA, the goal is to manage the symptoms and slow the disease progression. Medication, physical and occupational therapy and possible surgery may be necessary.
Let's take a look at some of the subjective and objective data that your patient with rheumatoid arthritis may present with. Now remember, subjective data are going to be things that are based on your patient's opinions or feelings. They might express fatigue, symmetrical joint stiffness and joint pain.
Objective data includes warmth of the joints, joint edema, dislocations, deformity of joints, including deviation of the hands, fever and weight loss.
Nursing interventions are a super important part of a care plan, so let's take a look at those. The primary complaints of patients with RA is intense pain and stiffness of those joints. To manage this pain, use pillow supports, warm compresses to loosen stiff joints and relax the muscles, cold compresses to numb the pain and reduce the swelling, and finally, PRN pain meds.
In addition to pain meds, other medications are necessary to treat RA. NSAIDS are given to reduce inflammation and ease pain. Steroids like prednisone are given to reduce inflammation and slow joint damage. Disease-modifying antirheumatic drugs like methotrexate are given to slow the progression of RA and save the joints and tissues from permanent DNA damage. Finally, biologic agents like rituximab are biologic response modifiers that work by targeting parts of the immune system that trigger inflammation.
Promoting self care in patients with RA is critical because as the disease progresses, it may be difficult for patients to perform ADL's such as feeding themselves or combing their hair. Provide tools such as eating utensils or toothbrushes with larger grips to encourage the patient to remain independent. Also, fatigue is a very common symptom of RA, so it's important to cluster care and promote rest. For your patients who have RA, help to promote a positive self image, as patients with joint deformities may experience a negative body image. Although these patients do fatigue easily, encourage exercise to help loosen those joints, so encourage activity as tolerated. Nutrition and lifestyle education is critical with RA patients. When patients are in pain, they sometimes want to turn to comfort foods, which is definitely understandable, but instead help them to make healthy food choices, avoid alcohol, avoid smoking and encourage hydration. Patients may also want to consult with a nutritionist regarding an anti-inflammatory diet.
Okay, guys, here is a look at the completed care plan for rheumatoid arthritis. We love you guys. Now, go out and be your best self today and as always, happy nursing!
RA is an auto-immune disease where the immune system mistakenly targets and attacks the joint linings causing uncontrolled inflammation of the synovium. Bilateral joints are affected, primarily the wrists, the hands, and also the knees. RA is characterized by bone erosion and joint deformity, so as the disease progresses, other joints may be affected symmetrically. Chronic inflammation and degenerative changes are the hallmark aspects of RA. Doctors are unsure of what triggers RA, but it appears to be partially genetic. The genetic predisposition makes the patient more susceptible to environmental factors like viruses and bacteria that may trigger the initial inflammation. Once the inflammation begins, the synovial fluid thickens and the tendons and ligaments stretch, resulting in the joint losing its shape and alignment. While there is no cure for RA, the goal is to manage the symptoms and slow the disease progression. Medication, physical and occupational therapy and possible surgery may be necessary.
Let's take a look at some of the subjective and objective data that your patient with rheumatoid arthritis may present with. Now remember, subjective data are going to be things that are based on your patient's opinions or feelings. They might express fatigue, symmetrical joint stiffness and joint pain.
Objective data includes warmth of the joints, joint edema, dislocations, deformity of joints, including deviation of the hands, fever and weight loss.
Nursing interventions are a super important part of a care plan, so let's take a look at those. The primary complaints of patients with RA is intense pain and stiffness of those joints. To manage this pain, use pillow supports, warm compresses to loosen stiff joints and relax the muscles, cold compresses to numb the pain and reduce the swelling, and finally, PRN pain meds.
In addition to pain meds, other medications are necessary to treat RA. NSAIDS are given to reduce inflammation and ease pain. Steroids like prednisone are given to reduce inflammation and slow joint damage. Disease-modifying antirheumatic drugs like methotrexate are given to slow the progression of RA and save the joints and tissues from permanent DNA damage. Finally, biologic agents like rituximab are biologic response modifiers that work by targeting parts of the immune system that trigger inflammation.
Promoting self care in patients with RA is critical because as the disease progresses, it may be difficult for patients to perform ADL's such as feeding themselves or combing their hair. Provide tools such as eating utensils or toothbrushes with larger grips to encourage the patient to remain independent. Also, fatigue is a very common symptom of RA, so it's important to cluster care and promote rest. For your patients who have RA, help to promote a positive self image, as patients with joint deformities may experience a negative body image. Although these patients do fatigue easily, encourage exercise to help loosen those joints, so encourage activity as tolerated. Nutrition and lifestyle education is critical with RA patients. When patients are in pain, they sometimes want to turn to comfort foods, which is definitely understandable, but instead help them to make healthy food choices, avoid alcohol, avoid smoking and encourage hydration. Patients may also want to consult with a nutritionist regarding an anti-inflammatory diet.
Okay, guys, here is a look at the completed care plan for rheumatoid arthritis. We love you guys. Now, go out and be your best self today and as always, happy nursing!
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