RA

Question 1

ra

Answer 1

• Chronic, progressive inflammatory disease affecting tissues and organs
• Autoimmune disease that is precipitated by WBCs attacking synovial tissue.

Question 2

Primarily affects …..

Answer 2

joints: Inflammatory synovitis.
- Involves joints bilaterally and symmetrically
- Affects several joints at the same time
- Typically affects upper joints first

Question 3

what happens in ra

Answer 3

• Synovial tissue becomes thick
• Inflammation extends to the cartilage, bone, tendons, and ligaments that surround the joint.
• Joint deformity and bone erosion

Question 4

Joint deformity and bone erosion can result from these changes

Answer 4

Decreases joints range of motion

Can effect any connective tissue in the body
- Blood vessels
- Pleural space
- Pericardium

Question 5

characterized by

Answer 5

exacerbations and remissions

Question 6

ra risk factors

Answer 6

• Female gender (3:1)
• 20-50 years old
• Genetic predisposition
• Mono
• Stress
• Environmental factors

Question 7

s/s

Answer 7

• 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

Question 8

diagnostic testing

Answer 8

• Anti-CCP antibodies
• Rheumatoid factor antibody
• ESR sedimentation rate:
  Elevated ESR is associated with inflammation or infection
• CRP
• ANA
• Elevated WBC

Question 9

20-40

Answer 9

mild inflammation

Question 10

40-70

Answer 10

moderate inflammation

Question 11

70-150

Answer 11

severe

Question 12

arthrocentesis

Answer 12

• 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

Question 13

xrays

Answer 13

determine degree of joint destruction

Question 14

nursing care

Answer 14

• 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

Question 15

meds

Answer 15

• NSAIDS
• COX-2 Enzyme blockers
• Corticosteroids: prednisone (can cause infection and fractures)

Question 16

Disease modifying anti-rheumatic drugs (DMARDS): Common Cytotoxic Agent: Methotrexate

Answer 16

• 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

Question 17

sjorgrens syndrome

Answer 17

• 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

Question 18

Secondary osteoporosis

Answer 18

• Immobilization caused by arthritis can contribute to development of osteoporosis
• Encourage weight bearing exercises as tolerated

Question 19

vasculitis (organ ischemia) Latent

Answer 19

• 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