BSN3C Group 2

Epistola, Java, Lamboso

01

A Case Discussion on

Rheumatoid
Arthritis
02 Objectives
After 20 minutes of case
presentation, the student nurses
will be able to:
1. Identify the common signs
and symptoms of the disease,
and their appropriate nursing
interventions.
2. Verbalize understanding of
which sign or symptom the
Rheumatoid Arthritis

drugs are indicated for.

3. Formulate priority nursing
diagnosis, outcome and
interventions for the client
referred to by the case.
Rheumatoid Arthritis 03
DEFINITION
Rheumatoid arthritis (RA) is an autoimmune disease and a chronic
inflammatory condition. It usually affects synovial joints. Cause for
RA is unknown, but because of environmental and lifestyle factors,
the gene for RA is triggered leading to the disease.

Definition and Risk Factors

RISK FACTORS
Women
Age
Family history
Smoking
Excess weight
04 Signs and Symptoms
Additional S/S
Weight loss
Fatigue
Anemia
Rheumatoid Arthritis
05
07 Case Details
M. DIAZ Heavy smoker
56 years old Prefers caffeinated drinks
Female
over water
PAIN AND SWELLING IN Family history of HTN and
BOTH FEET AND KNEES rheumatoid arthritis
Chief Complaint Health History

WBC = 4.5x1000 mm2

Rheumatoid Arthritis

Hgb = 10.8 g/dL

Hct = 30%
Elevated ESR and CRP
Abnormal Laboratory Values
08 Case Details
Four days prior to admission
felt stiffness on feet and knees
took pain reliever medication
Day after
stiffness worsened
joints swollen
Day before admission
Rheumatoid Arthritis

intolerable pain on knees and feet (pain

scale = 9/10)
History of Present Illness
 09
Treatment
Treatments include
pharmacologic (analgesics,
anti-inflammatory,
antirheumatic, NSAIDs,
corticosteroids), and non-
pharmacologic (low impact

Rheumatoid Arthritis
exercises, diet, hygiene and
patient education)
 10

Pharmacologic
Treatments

Rheumatoid Arthritis
11
Celecoxib
ANTIRHEUMATICS, NSAID
Inhibits the enzyme (COX-2). Has
analgesic, anti-inflammatory, and
antipyretic properties.

200MG/CAP BID PO 8AM-8PM

Rheumatoid Arthritis

Presentations are communication tools.

12 Prednisone
CORTICOSTEROID
Decreases inflammation by reversal
of increased capillary permeability
and suppression of
polymorphonuclear leukocytes
migration.

10MG PO OD 7AM
Rheumatoid Arthritis

Presentations are communication tools.

13 Glucosamine
Sulfate
NSAIDS/ ANTIRHEUMATIC
Play a role in the promotion and
maintenance of the structure and
function of cartilage in the joints of
Rheumatoid Arthritis

the body.
750MG PO BID 9AM-6PM
Presentations are communication tools.
14
Calciumade
CALCIUM, COMBINATION
WITH VITAMIN D
To aid strengthen bones, help make
joints flexible and assist to maintain
optimum bone function.
600 MG/PO - OD/9AM
Rheumatoid Arthritis

Inform the client for possible

gastrointestinal disturbances such as
bloating, constipation, flatulence and
nausea.
 15

Nonpharmacologic
Treatments

Rheumatoid Arthritis
16 Exercise
Rheumatoid Arthritis

STRETCHING WALKING
17 Exercise
Rheumatoid Arthritis

HAND
CYCLING SWIMMING
EXERCISES
Hygiene 18
Because of limitations in
mobility for patients with RA,
self-care can be difficult.

Maintain good oral hygiene.

Cut hair shorter for easier
washing and handling.
Consider sitting in a chair

Rheumatoid Arthritis
while showering.
Invest in easy wearable
clothes. Avoid choosing
button-ups and clothes with
zipper.
19 Outpatient
State name, dose, side effects,
frequency, and schedule for all
medications.
Emphasize changes of lifestyle (e.g.,
diet, activity, rest) necessary to
maintain health.
Demonstrate accurate and safe self-
administration of medications.
Introduce ways to cope with stress
Rheumatoid Arthritis

successfully, plans for regular, safe

exercise and rationale for obtaining
adequate rest.
Emphasize time and date of follow-up
appointments.
 20
Diet
Avoid foods high in purine
such as alcoholic beverages,
and organ meats like liver.
If the patient is anorexic,
suggest small but frequent
feedings.
Consume foods high in iron.

Rheumatoid Arthritis
Supplemental vitamins and
minerals are recommended,
such as omega-3
supplements.
 21
Diet
Breakfast
rice, boiled egg and fruit
juice
Lunch
Sinigang na Bangus and 1
cup of rice
Afternoon snacks
Peanut butter sandwich

Rheumatoid Arthritis
Dinner
Inihaw na Isda and half cup
of rice
22

Rheumatoid Arthritis
Thank you!
REFERENCES: 23
Ambardekar, N. (2011, March 7). The Best and Worst Foods for
Rheumatoid Arthritis (RA). WebMD; WebMD.
https://www.webmd.com/rheumatoid-arthritis/ra-foods

Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's textbook of

Medical-surgical nursing (14th ed.). Wolters Kluwer.

Lachtrupp, E. (2020, September 16). Rheumatoid Arthritis Diet Plan.

EatingWell; EatingWell.
https://www.eatingwell.com/article/7866119/rheumatoid-arthritis-

Rheumatoid Arthritis
diet-plan/

‌ yphoid Fever Nursing Care Management: Study Guide. (2020,

T
February 28). Nurseslabs. https://nurseslabs.com/typhoid-fever/