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008 autoimmunesp14

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008 autoimmunesp14

  1. 1. RHEUMATIC DISEASES
  2. 2. Objectives • Identify connective tissue diseases • Describe the nursing care for rheumatic diseases and rheumatoid arthritis • Identify the risks for rheumatoid arthritis • Lists signs and symptoms for rheumatoid arthritis • Describe the medical management for rheumatoid arthritis • Describe the pathophysiology and symptoms of SLE • Describe the medical management for SLE
  3. 3. Diffuse Connective Tissue Diseases • A group of chronic disorders characterized by diffuse inflammation and degeneration in the connective tissue • Cause is unknown but thought to have an immunologic basis • Characterized by a clinical course of exacerbations and remissions • Includes RA, SLE, scleroderma, polymyositis, and polymyalgia rheumatica
  4. 4. Systemic Effects: Extraarticular Features • Exacerbations & remission • Fever • Fatigue • Anemia • Lymph node enlargement • Any organ system may be involved; arteritis, neuropathy and other neurologic manifestations, scleritis, pericarditis, pleural effusion, splenomegaly, renal involvement • Skin and mucosal manifestations
  5. 5. Rheumatic Diseases • “Arthritis” • More than 100 different disorders • Affect primary the joints, but also muscles, bone, ligament, tendons, cartilage • Classification • Monoarticular or polyarticular • Inflammatory or noninflammatory
  6. 6. • Characterized by inflammation of joints, systemic manifestations • Treatment • Mild analgesics to • Provide pain relief • Reduce inflammation • Corticosteroids to treat inflammation • Radiation to suppress body’s abnormal antigen–antibody responses Rheumatoid Arthritis
  7. 7. Characteristic Degenerative Changes— “Degradation”
  8. 8. Clinical Manifestations • Pain • Joint swelling • Limited movement • Stiffness • Weakness • Fatigue
  9. 9. Patient Assessment and Diagnostic Findings • Health history: include onset of and evolution of symptoms, family history, past health history, and contributing factors • Raynauds’s Phenonmenon • Functional assessment • Arthrocentesis • X-rays, bone scans, CTs, and MRIs • Tissue biopsy • Blood studies
  10. 10. Nursing Interventions • Understanding of the underlying disease process guide; the nurse’s critical thinking to provide interventions • The extent of the disease process, and whether it is localized or more systemic, will also affect nursing activities
  11. 11. Nursing Process: The Care of the Patient with a Rheumatic Disease—Diagnoses • Acute and chronic pain • Fatigue • Disturbed sleep pattern • Impaired physical mobility • Self-care deficits • Disturbed body image • Ineffective coping
  12. 12. Medical Management • NSAIDs • Cox-2 Enzyme blockers • DMARDs • Methotrexate • Biologic therapies • Corticosteroids
  13. 13. Nursing Process: The Care of the Patient with a Rheumatic Disease—Planning • Major goals may include: • Relief of pain and discomfort • Relief of fatigue • Promotion of restorative sleep • Increased mobility • Maintenance of self-care • Improved body image • Effective coping • Absence of complications
  14. 14. • Chronic systemic disorder • Caused by development of antibodies that fight body’s own tissues, cells • Effects • Damage to connective tissues, the hematologic system, skin, kidneys, heart, brain • Treatment • Education in rest, stress management • Use of anti-inflammatory agents and corticosteroids Systemic Lupus Erythematosus
  15. 15. Teaching Patients Self-Care • Explain the disease and principles of disease management • Medication teaching • Monitoring • Sources of information • Pain management • Joint protection • Self-care with assistive devices • Exercise and relaxation

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