Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium (synovitis) secondary to hyperplasia of synovial cells, excess synovial fluid, and the development of pannus in the synovium. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in both its chronicity and progression, and RA is considered a systemic autoimmune disease.(wikipedia)
Nursing Assessment for Rheumatoid Arthritis
Assessment of patients depending on the severity and the involvement of other organs (eg eye, heart, lungs, kidneys), for example stages of remission and exacerbation of acute or existence with other forms of arthritis.
Activity / Rest
Symptoms: Joint pain due to movement, tenderness, worsened by stress on the joints; stiffness in the morning, usually bilateral and symmetrical. Functional limitations that affect lifestyle, leisure, work, fatigue.
Symptoms: Malaise, limited range of motion; atrophy of muscles, skin, contractors / abnormalities in the joints.
Cardiovascular
Symptoms: Raynaud's phenomenon fingers / legs (eg intermittent pallor, cyanosis, and redness of the fingers before the color returned to normal).
Ego integrity
Symptoms: Acute stress factors / chronic: eg, financial, employment, disability, relationship factors. Decisions and powerlessness (inability situation), Threats to the self-concept, body image, personal identity (eg dependence on others).
Food / fluid
Symptoms: Inability to produce / consume food / fluids adequate: nausea, anorexia, difficulty to chew.
Signs: Weight loss, dryness of mucous membranes.
Hygiene
Symptoms: The difficulties to carry out personal care activities. Dependence
Neuro Sensory
Symptoms: numbness, tingling in hands and feet, loss of sensation in the fingers.
Symptoms: Swollen joints symmetrically.
Pain / comfort
Symptoms: The acute phase of pain (may not be accompanied by soft tissue swelling in joints).
Security
Symptoms: Skin shiny, taut, subcutaneous nodules. Skin lesions, leg ulcers. Mild difficulties in handling the task / maintenance of the household. Persistent mild fever. Drought in the meta and mucous membranes.
Social interaction
Symptoms: Damage of social interaction with family / others; changing role; isolation.
Guidance / learning
Gajala History of rheumatoid arthritis (RA) in the family (at the onset of adolescence). The use of health foods, vitamins, "cure" arthritis without testing. History of pericarditis, valve lesions, pulmonary fibrosis, pleuritis.
