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Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune disorder characterized by chronic inflammation of the synovial tissue and joints, causing pain, swelling, stiffness and destruction of cartilage and bone. It affects more women than men and risk increases with age, family history, obesity, and smoking. The cause is unclear but involves autoantibodies attacking the synovium lining of joints. Diagnosis involves blood tests measuring inflammation markers like ESR, CRP, rheumatoid factor. Imaging like x-rays and MRIs show joint damage progression. Treatment focuses on reducing inflammation and joint damage through medications like NSAIDs, DMARDs and biologics, as well as surgery for advanced cases.

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Mel Christian Baldoz
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54 views15 pages

Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune disorder characterized by chronic inflammation of the synovial tissue and joints, causing pain, swelling, stiffness and destruction of cartilage and bone. It affects more women than men and risk increases with age, family history, obesity, and smoking. The cause is unclear but involves autoantibodies attacking the synovium lining of joints. Diagnosis involves blood tests measuring inflammation markers like ESR, CRP, rheumatoid factor. Imaging like x-rays and MRIs show joint damage progression. Treatment focuses on reducing inflammation and joint damage through medications like NSAIDs, DMARDs and biologics, as well as surgery for advanced cases.

Uploaded by

Mel Christian Baldoz
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Rheumatoid Arthritis (RA)

By: Baldoz, Mel Christian J. SN


Definition
 Rheumatoid Arthritis
 Is a chronic, systemic autoimmune disorder
whose major distinctive feature is chronic,
symmetrical, and erosive inflammation of the
synovial tissue of joints. The severity of the joint
disease may fluctuate over time, but progressive
development of various degrees of joint
destruction, deformity, and disability is the most
common outcome of established disease.
Synonymous term
 Degenerative Joint Disease
Risk Factors
 PreDisposing
 Precipitating
 Age (25-45)
 Gender (female)  Weight (obese)
 Family History  Smoking (long term)
(member of family that
has RA)
Causes/Etiology
 RA is characterized by the presence of
rheumatoid factor (RF), an autoantibody directed
against immunoglobulin G (IgG). The role of
autoantibodies in RA is still unclear, but research
has focused attention on pre-illness immunologic
status. Antikeratin antibody (AKA) and anti-
perinuclear factor (APF) appear to be markers that
predict the development of RA in RF positive
clients.
 (according to the Medical Surgical Nursing, 8th ed)
Causes/Etiology
 Rheumatoid arthritis occurs when your immune
system attacks the synovium, the lining of the
membranes that surround your joints. The
resulting inflammation thickens the synovium,
which can eventually invade and destroy the
cartilage and bone within the joint. The tendons
and ligaments that hold the joint together weaken
and stretch. Gradually, the joint loses its shape
and alignment.
 (according to www.mayoclinic.com)
Pathophysiology
Diagnostic Exam
 Complete blood count (CBC)
- A CBC tests for abnormalities in the three types of cells in your blood.
-Red blood cells carry oxygen to tissues; RA patients often have a low red
blood count which results in anemia and contributes to extreme fatigue.
-White blood cells help fight infections and may be high in RA patients, signaling
that infection is present.
-Platelet counts are elevated when inflammation is present in the body. It can
also be lowered by certain drugs.

 Erythrocyte Sedimentation Rate (ESR or sed rate)


-This test measures the speed that red blood cells fall to the bottom of a test tube; the
faster the red blood cells drop, the higher the rate of inflammation in the patient.

 C-Reactive Protein
-Much like the ESR test, the C-reactive protein (CRP) measures the degree of
inflammation, sometimes one will be raised when the other isn’t.
Diagnostic Exam
 Rheumatoid Factor (RF)
-Seventy to 80 percent of people with rheumatoid factor (RF) also have rheumatoid
arthritis. The presence of RF rises according to the severity of the disease.

 Antinuclear Antibodies (ANA)


-According to the Arthritis Foundation, “this test detects a group of autoantibodies
(antibodies against self), which is seen in about 30 to 40 percent of people with RA.
Although it commonly is used as a screening tool, ANA testing isn't used as a diagnostic
tool because many people without RA or with other diseases can have ANAs.

 Imaging
 X-rays
-images will show how the disease is progressing by showing small holes near the ends
of bones and loss of cartilage.
Diagnostic Exam
 Magnetic Resonance Imaging (MRI)
 This test can detect early inflammation better than an x-ray. It can pinpoint synovitis
(inflammation of the lining of the joint).
 Bone Densitometry (DEXA)
 Bone densitometry is important for measuring bone density, used primarily to detect
osteoporosis. Osteoporosis may be especially severe in people with RA due to joint
immobilization.
Signs and Symptoms
 Joint pain
 Joint swelling
 Joints that are tender to the touch
 Red and puffy hands
 Firm bumps of tissue under the skin on your arms
(rheumatoid nodules)
 Fatigue
 Morning stiffness that may last for hours
 Fever
 Weight loss
Medical management
 Analgesics
 NSAIDs
 DMARDs (Disease Modifying AntiRheumatic

Drugs) and BRMs (Biologic Response Modifiers)


 Glucocortocoids
Surgical Management
 Tendon Transfer and Osteotomy
 Synovectomy
 Arthrodesis
 Joint Replacement
Nursing Diagnosis
 1. Chronic Pain related to inflammation and
swelling from pressure on surrounding tissues,
joint deformity and joint destruction.

 2. Impaired physical mobility related to pain,


stiffness and joint deformity

 3. Readiness to enhance self-care related to high


risk of side effects of medication, health
maintenance and self-care
Tapoz na powh!!!
 Salamat

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