- More common in women 40-60 years old
- Genetics, remissions and exacerbations
- Fingers, hands, wrists, knees, feet
- Rheumatoid Factor – antibody that reacts with fragments of IgG
Signs and Symptoms
- Fatigue
- Anorexia
- Weight loss
- Crepitus
- Morning stiffness
- Increased ESR
- Pain
- Malaise
- Fever
- Increased capillary permeability
Pathophysiology
Viruses
↓
Alteration of IgG (foreign)
↓
Lymphocytes
↓
Rheumatoid factor
↓
Binding of rheumatoid factor to IgG
↓
Inflammatory response
↓
Leukocytes, monocytes, macrophages and lymphocytes
congregate
↓
Phagocytosis
↓
Release of lysosomal enzymes
↓
Destruction of joint cartilage
↓
Dislocation
↓
Fibrous formation
↓
Misalignment
Diagnostic Tests:
- x-ray showing bone demineralization and soft tissue selling
- Positive RF test
- Elevated serum globulins
- Elevated ESR
- Complete blood count shows moderate anemia and slight leukocytosis
Medical Management
1. Medications such as salicylates to decrease inflammation and
relieve joint pain
2. Cold therapy – if acute
3. Heat therapy – if chronic
4. Physical therapy, passive ROM, weight control, rest
Nursing Management
1. Assess joints and look for any deformities.
2. Monitor vital
signs.
3. Monitor weight.
4. Heat therapy to help relieve pain. Ice packs are
effective during acute episodes.
5. Administer due medications.
6. Encourage to take adequate sleep and rest.
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