Monday, June 18, 2012

Nursing Care Plan for Rheumatoid Arthritis - Diagnosis and Interventions

Nursing Care Plan for Rheumatoid Arthritis


Rheumatoid Arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as in other organs in the body. Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly attacked by their own immune system. The immune system contains a complex organization of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.

While rheumatoid arthritis is a chronic illness, meaning it can last for years, patients may experience long periods without symptoms. However, rheumatoid arthritis is typically a progressive illness that has the potential to cause joint destruction and functional disability.
Source : medicinenet.com

Nursing Diagnosis for Rheumatoid Arthritis
  1. Acute Pain / Chronic related to tissue distension by fluid accumulation / inflammation, joint destruction.
  2. Impaired physical mobility related to skeletal deformities, pain, discomfort, activity intolerance, decreased muscle strength.

Nursing Interventions for Rheumatoid Arthritis
Acute Pain / Chronic Pain related to tissue distension by fluid accumulation / inflammation, joint destruction.

Goal :

Pain is reduced / lost

Expected results :
  • Indicates no pain
  • Looks relaxed, to sleep / rest and participate in activities based on ability.
  • Following program prescribed pharmacologic
  • Combining the skills of relaxation and entertainment activity in the pain control program.

Nursing Intervention :
  • Assess pain, note the location and intensity (scale 0-10). Write down the factors that accelerate and signs of pain non-verbal.
    R / Assist in determining the need for pain management and program effectiveness.
  • Give a hard mattress, small pillows, elevate the bed linen as needed.
    R / soft mattress, large pillows, will prevent the maintenance of proper body alignment, placing stress on joints that hurt. Bed linen elevation decrease the pressure on painful joints.
  • Instruct to frequently change positions. Helps to move in bed, prop a pain in the joints above and below, avoid jerky movements.
    R / Prevent the occurrence of general fatigue and joint stiffness. Stabilize joints, reduce the movement / pain in the joints.
  • Instruct the patient to a warm bath or shower at the time awake. Monitor the water temperature, water bath, and so forth.
    R / Heat enhance muscle relaxation, and mobility, reduce pain and stiffness in the morning release. Sensitivity to heat, can be removed and dermal wound can be healed.
  • Give a massage
    R / enhance relaxation / reduce pain
  • Encourage the use of stress management techniques, such as progressive relaxation, therapeutic touch, biofeed back, visualization, guidelines imagination, self hypnosis, and breathing control.
    R / Increase relaxation, provide a sense of control and may improve coping abilities.
  • Engage in activities of entertainment that is suitable for individual situations.
    R / Focusing attention back, provide stimulation, and increased self-confidence and feeling healthy.
  • Give the drug prior to activity / exercise that is planned as directed.
    R / Increase relaxation, reduce muscle tension / spasm, making it easier to participate in therapy.
  • Collaboration: Provide drugs according to doctor's instructions.
    R / as anti-inflammatory and mild analgesic effect in reducing stiffness and increasing mobility.
  • Give the ice-cold compress if needed.
    R / The cold can relieve pain and swelling during the acute period.
Source : http://nanda-nursing.blogspot.com/2011/03/nursing-diagnosis-for-rheumatoid.html

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