Linda Akioyame, Laura Dunwell, Crystal Johnson, Kathlyn, Millare, Christina Porter, Whitney Slater, Trung Tu, Daryl Yann

 An autoimmune disorder that occurs when the immune system mistakenly attacks its own body tissues  Inflammation occurs in the lining of the joints, causing painful swelling that can eventually result in joint breakdown and deformity  Typically affects the small joints in the hands and the feet

 Red, swollen, painful, and tender joints in a symmetrical pattern  Rheumatoid nodules  Low-grade fever  Fatigue/Loss of energy  Lack of appetite  Sjogren’s syndrome (dry mouth and eyes)  Chest pain upon coughing or deep breathing d/t inflammation of lung lining  Decreased white and red blood cells  Felty’s syndrome (enlarged spleen)  Vasculitis (blood vessel inflammation)

 Normal adult results should be negative  positive or increase can indicate a possible RA or other connective tissue diseases. › measures the presence of unusual antibodies of immunoglobulins G (IgG) and M (IgM) › Not all positive titers are specific of RA especially in adults  A positive in this test can also be elevated in leukemia, liver disease, and renal disease  Recent blood transfusion may affect result  High lipid levels may cause a false-positive on test  Nursing Interventions – explain procedure, monitor site for bleeding, report abnormal findings

 This test shows the presence of inflammation in the body and the activity of the disease  Indications: Inflammation, rheumatoid arthritis, acute and chronic infection, rheumatoid/auto-immune infections  Normal range for males is up to 15mm/hr, and females up to 25mm/hr  Nursing Interventions: explain procedure, monitor site for bleeding, andreport abnormal readings

 Interrupts the immune system that promotes inflammation  Can slow or stop the progression sending RA into remission  Not only does it decrease pain and swelling, but also reduces damage to joints and can prevent long-term disability  Do not use methotrexate if the person has a liver disease, bone marrow disorder, blood cell disorder, pregnant, alcoholism, or active infection or hepatitis  SIDE EFFECTS Abdominal pain Chills or fever Dizziness Hair loss Headache Light sensitivity Itching Liver problems Low blood counts

 Help manage chronic pain, inflammation, and swelling › Prostaglandins are released by damaged tissues which trigger imflammation that results in pain and swelling › NSIADS b lock prostaglandins by blocking COX enzymes specifically, COX-1 & COX-2 do not slow RA progression  Ex. Ibuprofen (Advil, Motrin)  SIDE EFFECTS GI Bleeding Hepatitis Constipation Dyspepsia Nausea/Vomiting Abdominal Discomfort Headache

 Scheduling NSAIDs at equal intervals throughout the day  Taking morning NSAID dose with milk and crackers approximately 30 minutes before rising  Performing ROM exercises in shower or bathtub  Applying local heat with paraffin dip or compress; using cold packs as needed  Teach techniques to minimize joint stress while performing ADLs  Provide Arthritis Foundation literature and information  Discuss ways to delegate household tasks to other family members Teach techniques for relieving pain and morning stiffness including:

 Regular, moderate exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance.  Dealing with pain can be the hardest part of having arthritis, but pain can be managed by learning more about RA, treatments, preventative measures, and alternative remedies.  Optimal treatment for the disease involves a combination of medications, rest, joint- strengthening exercises, joint protection, and patient (and family) education.  Early treatment of rheumatoid arthritis results in better outcomes.

 What is the normal ESR range present in males and females with Rheumatoid Arthritis?

There is no known cure for RA, but individuals can reduce symptoms of the disease by: 1. Medications 2. Rest 3. Oral Hygiene 4. Joint-strengthening exercises 5. Joint protection 6. Patient and Family Teaching a)1,2,3,4,5,6 b)2,3,5,6 c)1,2,4,5,6 d)4,5,6

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