Risk Factors
genetics environmental factors hormonal
Classic Sx
symmetric joint involvement w/ pain & swelling of knuckles
& small foot bones
Late Sx
nodules joint deformities: ulnar drift (hand),
boutonniere deformity (hand), swan-neck deformity (hand), hallux
valgus (foot)
Lab / Dx
RF (rheumatoid factor) anti-CCP antibodies
ESR CRP CBC X-rays MRI
US
Nursing Interventions
pain: PT, assess Fx, joint care
fatigue: measure w/ scale, possibly d/t pain,
balance of rest & exercise
sleep deprivation: reinforce good habits, sleep
schedule, avoid caffeine/alcohol before bed, warm bed to ease joint
pain, afternoon nap may help assess perception of disease
activity in relation to Sx experienced assess gradual &
sudden changes in functional ability blood monitoring
monitor for SE from meds or disease process
Surgical Mgmt
tendon transfer & osteotomy synovectomy
arthrodesis joint replacement
Meds
Sx control:
corticosteroids NSAIDS
disease control:
DMARDS: methotrexate, sulfasalazine DMARDSII:
etanercept, anakinra, rituximab, abatacept, leflunomide
NDx
Acute / Chronic Pain Impaired Physical Mobility
Self-Care Deficit Disturbed Body Image