RA Flashcards
ra
- Chronic, progressive inflammatory disease affecting tissues and organs
- Autoimmune disease that is precipitated by WBCs attacking synovial tissue.
Primarily affects …..
joints: Inflammatory synovitis.
- Involves joints bilaterally and symmetrically
- Affects several joints at the same time
- Typically affects upper joints first
what happens in ra
- Synovial tissue becomes thick
- Inflammation extends to the cartilage, bone, tendons, and ligaments that surround the joint.
- Joint deformity and bone erosion
Joint deformity and bone erosion can result from these changes
Decreases joints range of motion
Can effect any connective tissue in the body
- Blood vessels
- Pleural space
- Pericardium
characterized by
exacerbations and remissions
ra risk factors
- Female gender (3:1)
- 20-50 years old
- Genetic predisposition
- Mono
- Stress
- Environmental factors
s/s
- Pain at rest and with movement
- Morning stiffness
- Pleuritic pain with inspiration
- Dry mouth
- Anorexia
- Fatigue
- Tingling/numbness
- Joint pain
- Joint swelling/deformity
- Subcutaneous nodules
- Muscle weakness
diagnostic testing
- Anti-CCP antibodies
- Rheumatoid factor antibody
- ESR sedimentation rate:
Elevated ESR is associated with inflammation or infection - CRP
- ANA
- Elevated WBC
20-40
mild inflammation
40-70
moderate inflammation
70-150
severe
arthrocentesis
- Synovial fluid aspiration by needle
Test will show increased WBC and RF in fluid if positive
- Nurse should monitor for leaking at biopsy site
- Give Tylenol for pain
xrays
determine degree of joint destruction
nursing care
- Apply heat or cold to affected area
- Assist with physical activity
- Monitor fatigue
- Maximize functional activity
- Minimize pain
- Monitor for skin breakdown
- Conserve energy
- Encourage routine health screening
- Administer medications as needed
- Provide patient teaching related to medications
- Encourage foods high in vitamins, protein, and iron
- Encourage small, frequent meals
meds
- NSAIDS
- COX-2 Enzyme blockers
- Corticosteroids: prednisone (can cause infection and fractures)
Disease modifying anti-rheumatic drugs (DMARDS): Common Cytotoxic Agent: Methotrexate
- Infusion is given once a week
Chemo like agent
- Reduces the bodies own immune abilities
- May cause renal dysfunction
- Patients may require hydration protocols
- Oral and IV
sjorgrens syndrome
- Dry eyes, mouth, and vagina
- Caused by obstruction of secretory ducts and glands
- Provide eye drops and artificial saliva, and recommended vaginal lubricants as needed
- Encourage fluid with meals
Secondary osteoporosis
- Immobilization caused by arthritis can contribute to development of osteoporosis
- Encourage weight bearing exercises as tolerated
vasculitis (organ ischemia) Latent
- Inflammation of arteries disrupts blood flow to organs causing ischemia.
- Commonly affects arteries of skin, eyes, and brain
- Monitor for skin lesions, decrease in vision, and cognitive dysfunction
