Rheumatoid Arthritis

Rheumatoid Arthritis by Ivan Satori

1. PATHOPHYSIOLOGY

2. MANIFESTATIONS

3. B A S I S #1: GENETIC COMPONENT (predisposition)

4. B A S I S #2: IMMUNOLOGIC TRIGGER

5. ENCOURAGEMENT FOR PERIODIC ACTIVITY

6. Individual's GENOME contains coding for particular Human Leukocyte Antigen (HLA) types

7. HLA-DR1

8. HLA-DR4

9. Deviant immune response occurs

10. HELPER T-Cell activation

11. CYTOKINE release

12. ANTIBODY formation

13. ETIOLOGY

14. ENVIRONMENTAL FACTORS

15. e.g., carcinogens

16. e.g., abnormal bacteria

17. CAUSE MODIFICATIONS IN JOINT TISSUE STRUCTURE

18. WHITE BLOOD CELLS FAIL TO RECOGNIZE MODIFIED JOINT TISSUE CELLS AS "SELF" CELLS

19. SIGNS

20. SYMPTOMS

21. pain

22. joint stiffnes

23. loss of appetite

24. periodic activity maintains joint range of motion

25. exercise should be performed as advised by Physiotherapist

26. TREATMENT

27. NURSING MANAGEMENT

28. DIAGNOSIS

29. CONSIDER COMORBIDITIES (such as Cardiovascular disease) IN ASSESSMENT

30. CAREFUL MONITORING OF CLIENT ON CERTAIN PHARMACOLOGICAL THERAPEUTICS

31. JOINT APPEARANCE

32. PHARMACOLOGICAL THERAPEUTICS

33. SOCIAL THERAPEUTICS

34. redness

35. heat

36. swelling

37. CLIENT HISTORY

38. PHYSICAL EXAMINATION

39. LAB TESTS

40. levels of RHEUMATOID FACTOR (RF)

41. LEUKOCYTE levels

42. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

43. Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

44. range of motion

45. spongy feel when joint is palpated

46. Corticosteroids

47. Emotional rest and relaxation

48. Decrease Sympathetic system activation

49. Decrease in global immune response

50. Physical rest and relaxation

51. Take pressure off affected joint

52. Decrease blood flow to affected joint

53. Aid in periodic relief of flare-up pain

54. Aggressively fight inflammatory response

55. Help reduce inflammation

56. Interfere with with several steps of immune response, aggressively limiting PROSTAGLANDIN formation and LEUKOCYTE function

57. CAUTION: most compounds can be toxic - monitor client frequently for adverse effects

58. Inhibit formation of PROSTAGLANDINS, which damage joint tissue

59. CAUTION: compounds can severely affect immune response, resulting in immunocompromized status of client; use for short-term intervention ONLY

60. METHOTREXATE: interferes with Purine metabolism; triggers release of potent anti-inflammatory Adenosine

61. CONSIDER HERBAL THERAPEUTICS FOR PROLONGED SYMPTOMS

62. e.g., thunder god vine (Tripterygium wilfordii); contains several compounds found to have anti-inflammatory effects