NUR 145 Module D- Mobility Review
Questions and Correct Answers
3 distinct characteristics of rheumatoid diseases ✅1) Autoimmunity
2) Inflammation
3) Degradation of Cartilage
Rheumatoid Arthritis Pathophysiology ✅-occurs on same joints on opposite sides of
body, starts at small joints (hands, fingers)
-Exact Mechanism is UNKNOWN
Known:
-Immune reaction in SYNOVIAL tissue leads to breakdown of Collagen
-Swelling & Proliferation of the Synovial membranes with Pannus Formation
-Leads to: Cartilage Destruction & Bone Erosion
-Loss of articular surface and motion of joint
CBC ✅Baseline cell count before treatment with medications. Check for anemia.
Antinuclear antibody (ANA) ✅Antibody produced against one's own DNA. None
specific for RA. Positive titer associated with RA.
Erythrocyte Sedimentation Rate (ESR)
C-reactive protein (CRP) ✅Elevated in acute phase of RA, used to monitor disease
progression.
Rheumatoid Factor ✅Present in most patients with RA. Screening test used to detect
antibodies found in serum of clients with RA.
Anti-CCP ✅specificity of about 95% at detecting RA.
Rheumatoid Arthritis (Diagnostics) ✅-CBC
-Antinuclear antibody (ANA)
-Erythrocyte Sedimentation Rate (ESR)
-C-reactive protein (CRP)
-Rheumatoid Factor
-Anti-CCP
-X Ray, MRI (no metal) Arthocentesis (Needle in joint to assess joint fluid)
Rheumatoid Arthritis Manifestations & Risk Factors ✅-Stiffness
-Pain
-Swelling
-Bilateral Effects
, -Erethyma in joint
-Warmth in joint
-knobby, tender joints
-lack of function
-anorexia
-weight loss
-effects body's ability to make RBC (anemia)
Late RA:
-subq Nodules
Risk Factors:
-Age
-Female
-Smoking
-Recent Bacterial or Viral infection
Prevention of RA ✅-use adaptive devices that prevent development of deformity of
inflamed joints during adls
-continue using affected joints and ambulating to maintain function and ROM
Rheumatioid Arthritis (Meds) ✅Intial Treatment: Salicylates (Aspirin) & nsaids
-Cox 2 enzyme blockers (less GI distress)
-Corticosteriods
-dmards (Biologic & non-biologic)
Dmards ✅-alter the course of inflammatory process
-can lead to increased risk for infection!
-suppress bone marrow
-Start as soon as possible after diagnosed (take up to 6 weeks to work)
-use NONBIOLOGIC first
-Biologic DMARD's
--Target a certain cell of molecule within the immune system (TNF, IL-6)
--Used only if Non-biologic DMARD's ineffective
--Increased risk of life-threatening infections
--May be used in combination with other meds
Complications of Rheumatoid arthritis ✅-ancolosis: joint fusion
-swan neck deformity
-bouchards nodules on knuckles (proximal)
-Heberdeen nodules on knuckles (distal)
-ulnar deviation
Rheumatoid Arthritis (Nursing Considerations) ✅- Prevent falls and accidents
- Small frequent meals
Questions and Correct Answers
3 distinct characteristics of rheumatoid diseases ✅1) Autoimmunity
2) Inflammation
3) Degradation of Cartilage
Rheumatoid Arthritis Pathophysiology ✅-occurs on same joints on opposite sides of
body, starts at small joints (hands, fingers)
-Exact Mechanism is UNKNOWN
Known:
-Immune reaction in SYNOVIAL tissue leads to breakdown of Collagen
-Swelling & Proliferation of the Synovial membranes with Pannus Formation
-Leads to: Cartilage Destruction & Bone Erosion
-Loss of articular surface and motion of joint
CBC ✅Baseline cell count before treatment with medications. Check for anemia.
Antinuclear antibody (ANA) ✅Antibody produced against one's own DNA. None
specific for RA. Positive titer associated with RA.
Erythrocyte Sedimentation Rate (ESR)
C-reactive protein (CRP) ✅Elevated in acute phase of RA, used to monitor disease
progression.
Rheumatoid Factor ✅Present in most patients with RA. Screening test used to detect
antibodies found in serum of clients with RA.
Anti-CCP ✅specificity of about 95% at detecting RA.
Rheumatoid Arthritis (Diagnostics) ✅-CBC
-Antinuclear antibody (ANA)
-Erythrocyte Sedimentation Rate (ESR)
-C-reactive protein (CRP)
-Rheumatoid Factor
-Anti-CCP
-X Ray, MRI (no metal) Arthocentesis (Needle in joint to assess joint fluid)
Rheumatoid Arthritis Manifestations & Risk Factors ✅-Stiffness
-Pain
-Swelling
-Bilateral Effects
, -Erethyma in joint
-Warmth in joint
-knobby, tender joints
-lack of function
-anorexia
-weight loss
-effects body's ability to make RBC (anemia)
Late RA:
-subq Nodules
Risk Factors:
-Age
-Female
-Smoking
-Recent Bacterial or Viral infection
Prevention of RA ✅-use adaptive devices that prevent development of deformity of
inflamed joints during adls
-continue using affected joints and ambulating to maintain function and ROM
Rheumatioid Arthritis (Meds) ✅Intial Treatment: Salicylates (Aspirin) & nsaids
-Cox 2 enzyme blockers (less GI distress)
-Corticosteriods
-dmards (Biologic & non-biologic)
Dmards ✅-alter the course of inflammatory process
-can lead to increased risk for infection!
-suppress bone marrow
-Start as soon as possible after diagnosed (take up to 6 weeks to work)
-use NONBIOLOGIC first
-Biologic DMARD's
--Target a certain cell of molecule within the immune system (TNF, IL-6)
--Used only if Non-biologic DMARD's ineffective
--Increased risk of life-threatening infections
--May be used in combination with other meds
Complications of Rheumatoid arthritis ✅-ancolosis: joint fusion
-swan neck deformity
-bouchards nodules on knuckles (proximal)
-Heberdeen nodules on knuckles (distal)
-ulnar deviation
Rheumatoid Arthritis (Nursing Considerations) ✅- Prevent falls and accidents
- Small frequent meals
