Introduction
Rheumatoid arthritis (RA) is a heterogeneous autoimmune disease that is chronic and acute, most likely to affect women and those between 35-50 years of age. The process of RA begins as an inflammation episode in the synovium, causes it to thicken and become edematous. Synovial inflammation results in joints that are swollen, tender, and stiff. The patient with RA may manifest symptoms of pain, morning stiffness, fatigue, weight loss, anxiety, and depression. (Chen, & Wang, 2007) Self-care abilities are affected by the clinical manifestations related to the disease process of RA.
Assessment
The health history is beneficial to identify the risk factor for those with close relatives suffering with the disease. Physical examination is reliable when assessing the joints, range of motion, and circulation. A developed multi-dimensional health assessment questionnaire that is completed by the patient at each visit in their rheumatology clinic can be scored and provide the physician a current status of their physical and psychological areas that might raise concern for poor self-care. Assessing the patients ESR, CRP levels, and rheumatoid factor provides information of the patients’ baseline laboratory values with any deviations.(Palmer, El Gaafary, & El Mideany, 2007) The nurse should assess the patients’ psychosocial aspects including, social support; knowledge; education level; and socioeconomic status due to the positive correlation with self-care. (Chen, & Wang, 2007)
Planning
With RA being a chronic disease with acute exacerbations and remissions, it has social, emotional, physical, and psychosocial complications. Impaired physical mobility is a problem associated with RA, due to the symptoms of morning s...
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...elf-care abilities with this disease.
References
Chen, s, & Wang, h. (2007). The relationship between physical function, knowledge of disease, social support and self-care behavior in patients with rheumatoid arthritis. Journal of Nursing Research, 15(3),183-92.
Makelainen , P, Vehvilainen-Julkunen, K, & Pietil, A. (2009). Change in knowledge and self-efficacy of patients with rheumatoid arthritis: a six-month follow-up study. International Journal of Nursing Practice, 15(5), 368-75.
Makelainen, P, Vehvilainen-Julkunen, K, & Pietil, A. (2007). Rheumatoid arthritis patients' education-contents and methods. Journal of Nursing & Healthcare of Chronic Illnesses, 16(11c), 258-67.
Palmer, D, El Gaafary, M, & El Mideany, Y. (2007). Rheumatology. improving patient care: measurement of outcome in rheumatoid arthritis. British Journal of Nursing, 16(16), 1010-5.
Rheumatoid arthritis is not curable. Medications will be recommended to relieve pain, reduce inflammation, slow the progression of RA, and save joints and tissues from permanent damage (Rheumatoid Arthritis, 2017). The most common medications are nonsteroidal anti-inflammatory drugs (NSAID) and disease-modifying antirheumatic drugs (DMARD), e.t.c. When having RA, it is important to exercise regularly, apply heat or cold to affected areas, relax, and eat healthy. Physical therapy is usually part of treatment for RA. The goal is to stimulate the bones, muscles, and joints to give them strength and flexibility (Physical Therapy for RA, n.d.). Foods that have lots of omega-3 (fish, chia seeds, flax seeds, and walnuts), high antioxidants like vitamin A, E, and C (berries, dark chocolate, spinach, kidney beans, pecans, and artichokes), and lots of fiber can help reduce inflammation (Foods that fight RA inflammation,
Moore, Dianne-Jo. "The importance of friendship." Arthritis Today, Nov.-Dec. 1988, p. 40+. General OneFile, link.galegroup.com/apps/doc/A7055948/ITOF?u=wylrc_wyomingst&sid=ITOF&xid=1a078a2f. Accessed 28 Nov. 2017.
Fibromyalgia is an extremely disabling condition associated with chronic widespread musculoskeletal pain and reduced pain thresholds (Wolfe et al., 2010)(Kelley et al., 2011). Observational studies have shown that over a 12 month period 25% of men and women surveyed over the age of 65 will consult a primary care physician for musculoskeletal pain (Jordan et al., 2010). Overall, between 46% and 80% of people over the age of 65 report experiencing pain on a daily basis and 15% of women and 10% of men over 50 report widespread musculoskeletal pain (Soldato et al., 2007; Thomas et al., 2004). The Centers for Disease Control and Prevention estimated in xxxx that fibromyalgia patients generated $6000 per patient per year in healthcare costs where as another recent study of administrative claims found that fibromyalgia healthcare costs may exceed $18,000 per patient annually (Wolfe et al., 1997). In a population study of ten chronic diseases, fibromyalgia was highest ranked for healthcare not received in the previous year and in long-term disability, pain, and poor self-rated health by survey participants (Kasman and Badley, 2004).
Bibliography: Arthritis Foundation, Understanding Arthritis (1986); Kelley, William N., et al., eds., Textbook of Rheumatology, 2d ed., (1985); McCarty, Daniel F., ed., Arthritis and Allied Conditions, 11th ed. (1988); Moll, J. M. H., Rheumatology in Clinical Practice (1987).
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
This topic came up recently to me because my grandmother was diagnosed with it. She could barely walk and could not do many little things like get out of bed, and tie her shoes. Since my mom is a physical therapist she knew what to do, but I didn’t really know what it was or how to help her. Most of the things I knew about “arthritis” was that it affects your bones, but this was much more than that. I also didn’t realize that it was Rheumatoid Arthritis not just normal arthritis,they are different because Rheumatoid Arthritis has to do with your joints unlike regular arthritis that has to do with the wear and tear of your bones. I wish I had known if I could prevent it or even if it is genetic and if I could develop it too. I also wanted to know what the symptoms were because all I knew about it was that she was in pain. I was scared she wasn’t going to live as long because she got this, so that is why I decided to write this paper.
There are many ways to categorize illness and disease; one of the most common is chronic illness. Many chronic illnesses have been related to altered health maintenance hypertension and cardiovascular diseases are associated with diet and stress, deficient in exercise, tobacco use, and obesity (Craven 2009). Some researchers define the chronic illness as diseases which have long duration and generally slow development (WHO 2013); it usually takes 6 month or longer than 6 month, and often for the person's life. It has a sluggish onset and eras of reduction for vanishing the symptoms and exacerbation for reappear the symptoms. Some of chronic illness can be directly life-threatening. Others remain over time and need intensive management, such as diabetes, so chronic illness affects physical, emotional, logical, occupational, social, or spiritual functioning. Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, all of these diseases are the cause of mortality in the world, representing 63% of all deaths. So a chronic illness can be stressful and may change the way a person l...
During my residency, I had the opportunity to work with the Rheumatology Rehabilitation team at the University of Alberta (U of A). I met passionate mentors in physical and occupational therapy dedicated to helping arthritis patients preserve and optimize joint function. There was one man with rheumatoid arthritis attending the program who said the most important learning point he wanted me to take away was how much his rheumatologist and the rehab team had changed his life. Prior to starting biologic therapy, he was completely debilitated in his day-to-day life and unable to perform simple activities such as picking up his young children. He now found himself not only with disease control, but also quality of life. I value the multidisciplinary approach in rheumatology and emphasis on treating the “whole” patient, rather than a single organ
Rheumatoid arthritis is a disease that has direct involvement with the immune system. This disease is considered to be degenerative and currently the only thing that can be done is manage the painful symptoms and suppress the self targeting actions by using immune suppressing drugs. The cause of rheumatoid arthritis is mostly unknown but there is a high amount of evidence that there are genetic predispositions for the disease. This being said however there are also environmental factors to asses these include, bacteria, viruses, fungi and other environmental factors. Doctors primarily use a physical examination to first suspect R.A. then send for blood work to confirm. There are many aspects to this disease and many questions left unanswered, the treatments available now are only temporarily and can in some cases cause more problems than benefits. Lab experiments and clinical trials are currently showing some great results and could within our lifetimes cure many autoimmune diseases including R.A..
What is Arthritis? Arthritis is inflammation of a joint bringing such symptoms as chronic joint pain, stiffness, and swelling. The Arthritis Society states that approximately 4.6 million Canadians are currently living with arthritis; by 2036 this number will increase to 7.5 million (1 in 5). Health care costs and loss of productivity amount to $33 billion, by the year 2031 this number is expected to double. (The Arthritis Society, 2014). According to Aging in Contemporary Canada, arthritis and rheumatism is the most common chronic health problem of Canadian seniors affecting 47%. (Chappell, McDonald, & Stones, 2008, p. 221). With over 100 types of arthritis varying from mild to severe the most common age related form is osteoarthritis (OA) affecting 1 in 10 Canadians. Approximately 13% of Canadians suffer with OA. Joint damage from OA accounts for 80% of hip replacement surgery and over 90% of knee replacement surgeries. (The Arthritis Society, 2014). Severe cases of OA can restrict the ability to participate in activities and consequently affect a person’s quality of life. At this time there is no cure for OA without a joint replacement. Although OA can affect all ages the purpose of this paper is to focus on the impact this disorder has on the daily activities and functioning on the aging population. Discussion will also highlight the origin and manifestations of this disorder and will examine current and future treatment options available.
Rheumatoid arthritis affects around 400,000 individuals within the UK, it is the most relentless chronic form of arthritis, and for adults it is the second most common form in patients (1). “RA is more prevalent among women than men, and usually develops in the fourth to fifth decades of life” (A). Rheumatoid arthritis is severe as it is a form of autoimmune disease, this is where the body’s immune system attacks and damages working tissue, due to the failure to recognise the difference between foreign cell and normal cells. For example it damages the synovial membrane surrounding the knee, and bone erosion begins. This damage to the working tissue triggers an inflammatory response causing fluid to build around the knee (2). However it can happen in any joint, this is why it’s such a large problem as you simply can’t inhibit the effects of the immune system, as it would leave you extremely vulnerable to more life threatening diseases. If effective treatment isn’t applied it could be disabling to patients, the inflammation causes pain, stiffness, muscle ache, rheumatoid nodules (lumps of tissue) and tiredness (3).
Any learning that occurs should focus on treatments, tests, and minimizing pain and discomfort as they improve they can shift their focus of learning (Kitchie, 2014, p.127). I will continue to provide a meeting location that is both comfortable and private. In the emotional aspect of M.M. and her family I will try to identify moments when members feel emotionally supported as it sets the stage for a teachable moment (Miller & Nigolian, 2011, p.56). I will also discuss with each member their previous coping strategies that used that have been successful and to encourage them to find a way to build on and strengthen these qualities. Using teaching methods that are interactive and allow patients equal contributions and participation can help promote health compliance (Habel, 2005,
Rheumatoid arthritis, also commonly known as RA, is one of the most severe forms of arthritis an individual can have. About 1.3 million people in the United States suffer from this autoimmune disease that attacks one’s joints. The immune system will mistakenly attack normal cells within the body which can lead to inflammation in certain areas. RA is a chronic long term disease that cause edema, stiffness, pain and limited function of many joints. Many patient who suffer from rheumatoid arthritis state that their symptoms become worse in the morning or very late in the evening. RA may be hard to detect in many patients because of its subtle symptoms. Because many diseases behave like RA, it is hard to tell if achy joints and stiffness is a reliable symptom for this disease. Weakness, low grade fevers, loss of appetite are some of the first symptoms patients’ experience. Some other major signs and symptoms to look for are dryness of the eyes, mouth, nose and throat, stiff, locked joints particularly in the knees and elbows, and numbness or tingling in the hands. Although RA is a progressive disease that cannot be cured it is best that patients begin their treatment during the early stages; otherwise it can lead to permanent damage of the bones, joints, and cartilage. There are many treatment forms that are used in treating this disease. Disease modifying antirhumatic drugs such as Methotrexate and anti-inflammatories such as Mobic, are two classes of drugs that are highly effective for treating rheumatoid arthritis.
Confronting the experience of being diagnosed with rheumatoid arthritis at a young age and the subsequent years of treatment that went along with it taught me how to take better care of my body and to improve my well-being. This has led to an additional passion of mine—to find innovative ways to encourage individuals to become more engaged in their own health and the health of significant others in their lives. Through public health, changes in an individual can lead
The Theory of Caregiver Stress was a significant breakthrough for the reasoning of why caregivers are so deeply affected by this job. “The Theory of Caregiver Stress was derived from the Roy Adaptation Model to use as basis in understanding the relationships among caregivers and the stress faced when caring for a chronically ill relative” (Tsai, 2003). The Theory of Caregiver stress is a middle-range theory used to predict the outcome for stress and other various side effects (Dobratz, 2011). These adverse effects are predicted by: Demographic Characteristics, Burden in Caregiving, Stressful life events, Social Support and Social Roles. Also, because of the multitude of different scenarios and background for both the patient and the caregiver, these categories are necessary to compare and effectively use the results. The theory makes four main assumptions regarding adaption: “environmental change; the caregivers’ perceptions will determine how they will respond to the environmental stimuli; the caregivers’ adaptation is a function of their environmental stimuli and adaptation level, and lastly the caregivers’ effectors are results of chronic caregiving such examples include marital satisfaction and self-...