26TH CASE SCENARIO. (NURSING) Rheumatoid Arthritis.

Age/Sex 52years woman.

Patient name:Ignorez,Maggi.

Doctor: Dr.Garcia, Nonyez.

MR :Q00000005.

Chief Complaint: Rheumatoid arthritis.

A 52years old woman with Rheumatoid arthritis comes to the clinic with her husband for a routine visit. The wife ask the nurse to explain Rheumatoid arthritis to her husband. The nurse answer should be based on the knowledge that rheumatoid arthritis involves the thickening of the synovial membrane with granulation tissue.

Rationale: Inflammation of synovial tissues in joints, fluids accumulate, pannus forms,bones and cartilage destroyed.

Rheumatoid arthritis is known as autoimmune, inflammatory type of arthritis that causes pain and deformities to the joints.

Allergy: NKDA.

Vital sign BP 133/78.

Hr. 78

RA 98

RR : 18

Temperature 97.9°F.

CASE SCENARIO 26TH (B).

A 56 years old man is being treated for rheumatoid arthritis .During the treatment period the patient says to the nurse .The doctor told me that the arthritis will continue to progress and there is a chance that I will end up totally crippled, it’s hopeless.

How should the nurse approach this patient?.

Answer: The nurse will discuss with patient the difficulty of coping with a chronic disease. Rationale is that Rheumatoid arthritis causes permanent changes in life style, body image, self esteem ,reduced socialization, role ,change and encourage discussion.

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26TH CASE SCENARIO. C

A 51years old with Rheumatoid arthritis is taught by the nurse to perform range of motion exercises. After a week of exercises of her fingers, which were previously slightly contracted and useless, are now able to grasp a spoon, so that she can feed herself. In implementing her plan of care, the nurse should.

Answer:

The nurse should point out small accomplishments that she makes. Why?.Because you want to encourage her to continue.

Questions:

(1)The nurse obtains a history from a 62years old female with rheumatoid arthritis. The woman states that she was diagnosed ten years ago. The nurse understands that the type of pain experienced by patients with rheumatoid arthritis is characterized with.

Answer:

(2) The nurse plans care of a twelve old girl with Rheumatoid arthritis. The nurse assesses the patient most recent laboratory studies. The nurse would expect which of the following laboratory results due to this disease.

Answer:

Elevated sedimentation rate. Due to inflammation process in direct and degree of inflammation, used to evaluate response to medication

Question:

The nurse performs discharge teaching with an 18years old girl recently diagnosed with Rheumatoid arthritis. Which of the following action is true regarding the information that the nurse should include in the discharge teaching.

Answer:

The patient should be told the probable course of the disease. Allow her to discuss feelings begin the process of acceptance of changes.

Question:

A 45years old patient with a ten years history of rheumatoid arthritis is being prepared for discharge from the hospital. In planning discharge teaching for this patient, which of the following objectives is most essential for the nurse to include?.

Answer:

(A)Well autoimmune disease and there is no help.

(B)Maintain mobility. Which is most importantly achieved by exercises and independent ADL.

(C) All of the above.

(D)None of the above.

CORRECT ANSWER is B.