# data[].attributes.body
The treatment for rheumatoid arthritis include medications, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, disease-modifying antirheumatic drugs (DMARDs), biologic response modifiers, surgery, and physical therapy.

# data[].attributes.attachment_link.readable_text
Rheumatoid Arthritis Nursing Care Plans Diagnosis and Interventions

Rheumatoid Arthritis NCLEX Review and Nursing Care Plans
Rheumatoid arthritis (RA) is an inflammatory disorder that primarily affects the joints, but can also damage the skin, lungs, eyes, and the cardiovascular system.
It is long-term autoimmune disorder that happens when the immune system attacks the tissues that line the joints even if there is no infection in the site.

Rheumatoid arthritis is caused by joint swelling and joint stiffness which can result to joint deformity and bone erosion.

Signs and Symptoms of Rheumatoid Arthritis

Swelling of the joints

Joint stiffness and/or pain - worse during the mornings or after being inactive such as taking a nap or watching TV

Warm sensation on the affected joints

Loss of appetite

Deformed joints, especially in the fingers and toes

Causes and Risk Factors for Rheumatoid Arthritis

The immune system mistakenly attacks the membrane lining of the joints known as the synovium.

This causes inflammation and thickening of the synovium.

Eventually, the cartilage and bone inside the joint are destroyed, and the tendons and ligaments experience weakening and stretching, which are the reasons why rheumatoid arthritis patients have deformed joints in the fingers and toes.

The root cause of the autoimmune attack to the joints is still unknown, although experts are looking at the strong possibility of RA being a genetic disorder.

The risk factors for RA include age (usually starts in 40s), sex (women are more at risk than men); family history, smoking, obesity, and exposure to silica or asbestos.

Complications of Rheumatoid Arthritis

1. Rheumatoid nodules. RA puts a person at risk of developing rheumatoid nodules, which are firm clumps of tissue that form around the elbows, or other pressure points. They can be dangerous as these nodules can also form in the lungs. If they rupture in the lungs, collapsed lung may follow.

2. Osteoporosis and fractures. Aside from the affected joints, the nearby bones can eventually weaken, making the patient at a high risk for developing fractures.

3. Sjogren's syndrome. RA patients are at risk for developing this disorder, which reduces the moisture in the eyes and oral mucosa, resulting to dryness.

4. Carpal tunnel syndrome. The wrists may also be affected by RA, causing them to be inflamed and compress the median nerve that innervates the hand and fingers.

Diagnosis of Rheumatoid Arthritis

Physical exam - to check for the signs and symptoms such as joint redness, swelling, or warmth, as well as muscular strength and reflex exams

Blood tests - Complete blood count to check for increased ESR and CRP; specific blood tests for rheumatoid factor and anti-CCP antibodies

Imaging - X-ray of the affected joints; MRI and ultrasound to determine the severity

Treatment for Rheumatoid Arthritis

1. Medications. Depending on the severity of RA, doctors can prescribe:

2. Nonsteroidal anti-inflammatory drugs (NSAIDs) - to reduce inflammation and relieve pain

3. Steroids - to slow down the damage of the joints, reducing inflammation and pain

4. Disease-modifying antirheumatic drugs (DMARDs) - to slow down RA progression, reducing the risk for permanent tissue and joint damage

5. Biologic response modifiers - DMARDs that target specific parts of the immune system that stimulates the inflammation

6. Surgery. If the medications do not work, the doctor may recommend surgery to resolve joint damage. This includes synovectomy (removal of the inflamed synovium), tendon repair, and joint fusion (for realignment and stabilization of the affected joint).

7. Physical therapy. This is an important part of the treatment regimen for RA and includes a physical therapist who can guide the patient with effective exercises to maintain the flexibility of the joints.

Nursing Diagnosis for Rheumatoid Arthritis

Nursing Care Plan for Rheumatoid Arthritis 1

Nursing Diagnosis: Pain related to joint inflammation secondary to rheumatoid arthritis, as evidenced by pain score of 10 out of 10, guarding sign on the affected fingers, restlessness, and irritability

Desired Outcome: The patient will report a pain score of 0 out of 10.

Rheumatoid Arthritis Nursing Interventions Rationales

Assess the patient's vital signs. Ask the patient to rate the pain from 0 to 10 and describe the pain he/she is experiencing.

To create a baseline set of observations for the patient. The 10-point pain scale is a globally recognized pain rating tool that is both accurate and effective.

Administer analgesics/ pain medications as prescribed. Administer other prescribed medications for rheumatoid arthritis.

To provide pain relief to the patient. The medications for RA include: Nonsteroidal anti-inflammatory drugs (NSAIDs) - to reduce inflammation and relieve painSteroids - to slow down the damage of the joints, reducing inflammation and pain Disease-modifying antirheumatic drugs (DMARDs) - to slow down RA progression, reducing the risk for permanent tissue and joint damageBiologic response modifiers - DMARDs that target specific parts of the immune system that stimulates the inflammation

Ask the patient to re-rate his/her pain 30 minutes to an hour after administering the analgesic.

To assess the effectiveness of treatment.

Provide more analgesics at recommended/prescribed intervals.

To promote pain relief and patient comfort without the risk of overdose.

Reposition the patient in his/her comfortable/preferred position. Encourage pursed lip breathing and deep breathing exercises.

To promote optimal patient comfort and reduce anxiety/ restlessness.

Refer the patient to a pain specialist as required.

To enable to patient to receive more information and specialized care in pain management if needed.

Nursing Care Plan for Rheumatoid Arthritis 2

Nursing Diagnosis: Activity intolerance related to joint inflammation and pain secondary to rheumatoid arthritis, as evidenced by pain score of 8 to 10 out of 10, fatigue, disinterest in ADLs due to pain, verbalization of tiredness and generalized weakness

Desired Outcome: The patient will demonstration active participation in necessary and desired activities and demonstrate increase in activity levels.

Rheumatoid Arthritis Nursing Interventions Rationales

Assess the patient's activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.

To create a baseline of activity levels and mental status related to acute pain, fatigue and activity intolerance.

Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Alternate periods of physical activity with 60-90 minutes of undisturbed rest.

To gradually increase the patient's tolerance to physical activity. To prevent triggering of acute pain by allowing the patient to pace activity versus rest.

Administer analgesics as prescribed prior to exercise/ physical activity. Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room.

To provide pain relief before an exercise session. To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.

Refer the patient to physiotherapy / occupational therapy team as required.

To provide a more specialized care for the patient in terms of helping him/ her build confidence in increasing daily physical activity.

Other Nursing Diagnosis for Rheumatoid Arthritis

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon

Disclaimer:

Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

# data[].attributes.attachment_link.title
Rheumatoid Arthritis Nursing Diagnosis and Nursing Care Plan - NurseStudy.Net

# data[].attributes.attachment_link.description
Rheumatoid Arthritis NCLEX Review and Nursing Care Plans Rheumatoid arthritis (RA) is an inflammatory disorder that primarily affects the joints, but can also damage the skin, lungs, eyes, and the cardiovascular system. It is long-term autoimmune disorder that happens when the immune system attacks the tissues that line the joints even if there is no infection in the site.

# data[].attributes.body
-Education and counseling can help better understand the nature of rheumatoid arthritis and cope with the challenges it entails.
-Biofeedback(a technique that teaches you to control certain body functions) and cognitive behavioral therapy (a form of therapy that helps you learn to change how you react to the situation) could help.

# data[].attributes.attachment_link.title
What is Rheumatoid Arthritis? | Johns Hopkins Rheumatology

# data[].attributes.attachment_link.title
Rheumatoid Arthritis - Treatment | Johns Hopkins

# data[].attributes.attachment_link.title
Rheumatoid Arthritis Nursing NCLEX Lecture: Symptoms, Treatment, Interventions, Medications

# data[].attributes.headline
Rheumatoid Arthritis Characteristics & Treatment

# data[].attributes.subject
Rheumatoid Arthritis Characteristics & Treatment

# data[].attributes.body
A fun, educational quiz

# data[].attributes.attachment_link.readable_text
1. Rheumatoid Factor is:

1. An auto antibody producing organ found in those with rheumatoid arthritis.

2. A cell located in the joints of arthritis sufferers.

3. A hormone that indicates the presence of rheumatoid arthritis.

4. A type of neurotransmitter that blocks rheumatoid arthritis from forming.

5. A type of auto antibody sometimes found in patients with rheumatoid arthritis.

2. Upon a full examination of a new patient, Dr. Crane suspects Rheumatoid Arthritis more likely than Osteoarthritis. Which of the following consideration would MOST strongly lead to this conclusion?

1. The patient does not have a symmetrical presentation of joint problems.

2. The patient is an older patient.

3. The patient developed their joint problems over a period of many years.

4. The patient does not have any accompanying non-joint symptoms, such as fever.

5. The patient has swollen joints and systemic signs of disease including fever.

A Premium account gives you access to all lesson, practice exams, quizzes & worksheets

Access to all video lessons

Quizzes, practice exams & worksheets

Certificate of Completion

Create an account to get started Create Account

About This Quiz & Worksheet

Use this quiz/worksheet combo to help you test your understanding of characteristics and treatment of rheumatoid arthritis. Topics you'll be assessed on include things to look for when testing for RA as well as comparing RA with osteoarthritis.

Quiz & Worksheet Goals

In these assessments you'll be tested on:

Things to look for when testing for rheumatoid arthritis

Defining rheumatoid factor

Comparing RA with osteoarthritis

Initial damage of RA

Skills Practiced

This quiz and worksheet allow students to test the following skills:

Reading comprehension - ensure that you draw the most important information from the related lesson on rheumatoid arthritis

Critical thinking - apply relevant concepts to examine information about RA in a different light

Information recall - access the knowledge you've gained regarding who is more likely to be affected by RA

Knowledge application - use your knowledge to answer questions about the early damage done by RA and things to look for when testing for it

Additional Learning

To learn more about autoimmune disorders, review the accompanying lesson, What is Rheumatoid Arthritis? - Causes, Symptoms & Treatment. This lesson covers the following objectives:

Define the condition known as rheumatoid arthritis (RA)

Tell two risk factors for developing RA

Identify the causes of RA, including autoantibodies

Know two autoantibodies commonly detected in the blood of RA patients

Relate five signs associated with this condition

Compare and contrast RA with osteoarthritis

Explain treatments associated with RA

Explore our library of over 84,000 lessons

# data[].attributes.body
The result of rheumatoid arthritis is painful joints, swelling and stiffness.

# data[].attributes.body
In short, rheumatoid arthritis is inflammation in the joints and can be caused by a range of things from autoimmune disease to injuries and infections.

# data[].attributes.attachment_link.readable_text
Instructor: Artem Cheprasov Show bio

Artem has a doctor of veterinary medicine degree.

Rheumatoid arthritis is an autoimmune disorder that generally affects the joints of the hands and the feet. Understand this bad form of arthritis, the definition, and cause of rheumatoid arthritis, and examine the clinical signs, symptoms, diagnostics, and treatment of this autoimmune disease. Updated: 09/26/2021

A Really Bad Form of Arthritis

You've surely heard of something known as arthritis. In short, it's the inflammation of the joints. It's painful and can be caused by all sorts of things, ranging from autoimmune diseases to injuries and infections. However, one of the absolute worst forms of arthritis you can get - one that's extremely painful and even disfiguring - will be discussed in this lesson.

Video

Quiz

Course

This specific form of arthritis is called rheumatoid arthritis, or RA, for short. This is an autoimmune disorder that can commonly affect the joints of the hands and feet. While genetics seem to play a role in the development of this condition, other things may cause you to be more likely to suffer from rheumatoid arthritis. For instance, smoking has been shown to more than double the chances you'll get this disease. Another risk factor for developing rheumatoid arthritis is your sex. It seems that women are two to three times more likely to develop this condition than men, although the exact reason for this is unclear.

Causes

What we do know about RA is that there are antibodies that trigger an inflammatory response by reacting and attaching to an individual's own body's proteins. These antibodies are called autoantibodies. They are produced by cells of your immune system known as B-cells, which are in turn activated by T-cells. ACPA and rheumatoid factor are two types of autoantibodies commonly detected in the blood of rheumatoid arthritis patients.

The autoantibodies trigger the inflammatory response to occur wherever they lodge or attach to. In our case, the place that is most affected by these autoantibodies initially is the synovial membrane of a joint. The synovial membrane is a thin membrane that combines with the fibrous membrane to form the joint capsule. A joint capsule is a sac composed of the fibrous and synovial membranes that surround a joint.

So, again, once these autoantibodies attach, they trigger the process of inflammation which first damages the synovial membrane and then the cartilage of the joint itself, resulting in very painful erosions of the cartilage and the disfigurement of the joint. Usually, antibodies are supposed to do you good. They are launched by your body to try and fight off a foreign invader. But sometimes, be it due to genetics, infections, drugs, and so forth, autoantibodies are produced instead.

You can essentially liken the autoantibodies to a heat-seeking missile. It may have been launched against an enemy plane, but got diverted and shot down a friendly plane instead, causing a fiery explosion that we know as inflammation. The fire causes the destruction of anything it comes into contact with, including your joints.

Clinical Signs, Symptoms, and Diagnostics

This inflammatory process causes the typical signs associated with RA:

Warm, tender, and swollen joints

Pain

Rheumatoid nodules, which are swellings, with centers of decaying tissue, that are located underneath the skin overlying a joint as a result of the inflammation associated with rheumatoid arthritis

Fatigue and fever

Heart problems

When diagnosing RA, there's an important consideration. You need to be able to distinguish osteoarthritis from rheumatoid arthritis. Osteoarthritis is a degenerative arthritis that occurs when wear and tear leads to deterioration of cartilage and overgrowth of bone. Rheumatoid arthritis is the inflammation of a joint's tissues, which eventually leads to the destruction of cartilage.

In fact, let's play a game of doctor. You can be the doctor. Read off the list, and make a diagnosis by comparing the two different forms of arthritis that may be occurring in your patient.

So in rheumatoid arthritis:

It may occur at any time in a person's life

Causes systemic signs, such as fever, fatigue, and heart problems

Affects joints on both sides of the body at the same time

Causes joint changes more quickly, within a matter of months

Joints are more swollen than in osteoarthritis

Osteoarthritis, compared to RA:

To unlock this lesson you must be a Study.com Member.
Create your account

Register to view this lesson

Are you a student or a teacher?

Unlock Your Education

See for yourself why 30 million people use Study.com

Become a Study.com member and start learning now.

Become a Member

Already a member? Log In

Back

Resources created by teachers for teachers

Over 30,000 video lessons & teaching resources‐all in one place.

Video lessons

Quizzes & Worksheets

Classroom Integration

Lesson Plans

I would definitely recommend Study.com to my colleagues. It’s like a teacher waved a magic wand and did the work for me. I feel like it’s a lifeline.

Back

Create an account to start this course today

Used by over 30 million students worldwide

Create an account

# data[].attributes.attachment_link.readable_text
1. A patient has swelling and pain in the joints and experiences fatigue. Her blood test shows a low rheumatoid factor. What condition does she likely have?

1. Seropositive rheumatoid arthritis

2. Antibody inflammatory disorder

3. Seronegative rheumatoid arthritis

4. She likely does not have a diagnosable condition

2. Which of the following is not a common symptom of seronegative rheumatoid arthritis?

1. Joint pain

2. Loss of range of motion

3. Severe muscle cramping

4. Joint swelling

A Premium account gives you access to all lesson, practice exams, quizzes & worksheets

Access to all video lessons

Quizzes, practice exams & worksheets

Certificate of Completion

Create an account to get started Create Account

About This Quiz & Worksheet

In this quiz/worksheet combo, we've put together a series of multiple-choice questions about seronegative rheumatoid arthritis for your review. When you answer these questions, you'll test yourself on subjects including the symptoms of seronegative rheumatoid arthritis and what the rheumatoid factor is.

Quiz & Worksheet Goals

Our quiz is a handy way to see if you know:

The kind of disease seronegative rheumatoid arthritis is classified as

The condition related to a low rheumatoid factor in the blood, fatigues and pain and swelling in the joints

What the symptoms of seronegative rheumatoid arthritis look like

The definition of the rheumatoid factor

How to describe the treatment possibilities for rheumatoid arthritis

Skills Practiced

Knowledge application - use your knowledge to answer a question concerning how seronegative rheumatoid arthritis is classified

Information recall - access the knowledge you've gained regarding the treatment options for rheumatoid arthritis

Reading comprehension - ensure that you draw the most important information from the related lesson about seronegative rheumatoid arthritis

Additional Learning

To study this subject in greater detail, check out our lesson called What is Seronegative Rheumatoid Arthritis? - Symptoms & Treatment. After reviewing this lesson, you should be able to:

Explain how seronegative rheumatoid arthritis differs from arthritis

Define seronegative and the antibodies it refers to with regard to seronegative rheumatoid arthritis

Discuss the anti-CCP method and what it means if the test comes back positive

Explore our library of over 84,000 lessons