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

2.  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

4.  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)

5.  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

6.  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

7.  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

8.  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

9.  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:

10.  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.

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

12. 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

13. Carey, RC. (2006, Semptember 30). Rheumatoid arthritis. Retrieved from http://www.labtestsonline.org/understanding/conditions/rh eumatoid-2.htmlhttp://www.labtestsonline.org/understanding/conditions/rh eumatoid-2.html Mayo Clinic. (2009, November 3). Rheumatoid arthritis. Retrieved from http://www.mayoclinic.com/health/rheumatoid- arthritis/DS00020http://www.mayoclinic.com/health/rheumatoid- arthritis/DS00020 Shiel, W. C. (2009, April 08). Rheumatoid arthritis. Retrieved from http://www.medicinenet.com/rheumatoid_arthritis/article.h tmhttp://www.medicinenet.com/rheumatoid_arthritis/article.h tm Van Leeuween, AV. (2006). Laboratory and diagnostic tests with nursing implication. PHILADELPHIA: F.A Davis Company. (2009, November 30). Rheumatoid arthritis guide. Retrieved from http://www.webmd.com/rheumatoid- arthritis/guide/rheumatoid-arthritis-medicationshttp://www.webmd.com/rheumatoid- arthritis/guide/rheumatoid-arthritis-medications (2009). Rheumatoid arthritis. Retrieved from http://www.medicinenet.com/rheumatoid_arthritis_pictures _slideshow/article.htmhttp://www.medicinenet.com/rheumatoid_arthritis_pictures _slideshow/article.htm (2009). Rheumatoid arthritis. Retrieved from http://www.arthritis.org/disease-center.php?disease_id=31http://www.arthritis.org/disease-center.php?disease_id=31