This document provides an overview of rheumatoid arthritis, including its definition, signs and symptoms, causes, risk factors, complications, diagnosis, treatment, and nursing care. Rheumatoid arthritis is an autoimmune disorder where the immune system attacks joints, causing painful swelling. It most commonly affects adults over 50 and women. Smoking and excess weight can increase risk. Treatment focuses on reducing inflammation and symptoms through medications like NSAIDs, steroids, and disease-modifying drugs. Nurses assess patients, provide comfort measures, educate on disease management, and ensure patients can care for themselves.

2. OBJECTIVE
• Define Rheumatoid arthritis
• Sign and symptoms
• Itiology, risk factor and
complication.
• Traetment and medication.
• Assessment,diagnosis,interventio
n and evaluation.

3. INTRODUCTION
• Rheumatoid arthritis is a chronic inflammatory
disorder that can affect more than just your
joints. In some people, the condition can
damage a wide variety of body systems,
including the skin, eyes, lungs, heart and blood
vessels
• An autoimmune disorder, rheumatoid arthritis
occurs when your immune system mistakenly
attacks your own body's tissues.

4. DEFINITION
• Rheumatoid arthritis, or RA, is an
autoimmune and inflammatory disease,
which means that your immune system
attacks healthy cells in your body by mistake,
causing inflammation (painful swelling) in the
affected parts of the body. RA mainly attacks
the joints, usually many joints at once

5. S/S
• Signs and symptoms of rheumatoid arthritis
may include:
• Warm, swollen joints
• Joint stiffness that is usually worse in the
mornings and after inactivity
• Fatigue, fever and loss of appetite

6. ETIOLOGY
Arthritis may be caused by :
• wear and tear of a joint from overuse.
• age (RA is most common in adults over age 50)
• injuries.
• obesity.
• autoimmune disorders.
• genes or family history.
• muscle weakness.

7. RISK FECTORS
Factors that may increase your risk of rheumatoid arthritis include:
• Your sex. Women are more likely than men to develop rheumatoid
arthritis.
• Age. Rheumatoid arthritis can occur at any age, but it most
commonly begins in middle age.
• Family history. If a member of your family has rheumatoid arthritis,
you may have an increased risk of the disease.
• Smoking. Cigarette smoking increases your risk of developing
rheumatoid arthritis, particularly if you have a genetic
predisposition for developing the disease. Smoking also appears to
be associated with greater disease severity.
• Excess weight. People who are overweight appear to be at a
somewhat higher risk of developing rheumatoid arthritis.

8. COMPLICATIONS
• Rheumatoid arthritis increases your risk of developing:
• Osteoporosis. Rheumatoid arthritis itself, along with some
medications used for treating rheumatoid arthritis, can increase
your risk of osteoporosis — a condition that weakens your bones
and makes them more prone to fracture.
• Rheumatoid nodules. These firm bumps of tissue most
commonly form around pressure points, such as the elbows.
However, these nodules can form anywhere in the body,
including the heart and lungs.
• Dry eyes and mouth. People who have rheumatoid arthritis are
much more likely to develop Sjogren's syndrome, a disorder that
decreases the amount of moisture in the eyes and mouth.

9. DIAGNOSIS
• Rheumatoid arthritis can be difficult to
diagnose in its early stages because the early
signs and symptoms mimic those of many other
diseases. There is no one blood test or physical
finding to confirm the diagnosis.
• During the physical exam, your doctor will check
your joints for swelling, redness and warmth.
He or she may also check your reflexes and
muscle strength

10. IMAGING
• Your doctor may recommend X-rays to help
track the progression of rheumatoid arthritis
in your joints over time. MRI and ultrasound
tests can help your doctor judge the severity
of the disease in your body.

11. TREATMENT
• There is no cure for rheumatoid arthritis. But
clinical studies indicate that remission of
symptoms is more likely when treatment
begins early with medications known as
disease-modifying antirheumatic drugs
DMARDs
(azathioprine,leflunomide,hydroxychloroquine
,sulfasalazine).

12. MEDICATION
• The types of medications recommended by your
doctor will depend on the severity of your
symptoms and how long you've had rheumatoid
arthritis
• NSAIDs
• Steroids. Corticosteroid medications, such as
prednisone
• Conventional DMARDs. These drugs can slow the
progression of rheumatoid arthritis

13. NURSING ASSESMENT
• The assessment of a patient with RA can contribute
to its diagnosis.
• History and physical exam. The history and physical
examination address manifestations such as bilateral
and symmetric stiffness, tenderness, swelling, and
temperature changes in the joints.
• Extra-articular changes. The patient is also assessed
for extra-articular changes and these include weight
loss, sensory changes, lymph node enlargement,
and fatigue.

14. NURSING DIAGONSIS
• Bases on the assessment data, the major nursing
diagnoses appropriate for the patient are:
• Acute and chronic pain related to inflammation and increased
disease activity, tissue damage, fatigue, or lowered tolerance level.
• Fatigue related to increased disease activity, pain, inadequate
sleep/rest, deconditioning, inadequate nutrition, and emotional
stress/depression
• Impaired physical mobility related to decreased range of motion,
muscle weakness, pain on movement, limited endurance, lack or
improper use of ambulatory devices.
• Self-care deficit related to contractures, fatigue, or loss of motion.
• Disturbed body image related to physical and psychological
changes and dependency imposed by chronic illness.

15. NURSING INTERVENTIONS
• Provide a variety of comfort measures (eg,
application of heat or cold; massage, position
changes, rest; foam mattress, supportive pillow,
splints; relaxation techniques, diversional activities).
• Administer anti-inflammatory, analgesic, and slow-
acting antirheumatic medications as prescribed.
• Individualize medication schedule to meet patient’s
need for pain management.
• Teach pathophysiology of pain and rheumatic
disease, and assist patient to recognize that pain
often leads to unproven treatment methods.

16. EVALUATION
Expected outcomes include:
• Improved comfort level.
• Incorporated pain management techniques into
daily life.
• Incorporated strategies necessary to modify fatigue
as part of the daily activities.
• Attained and maintained optimal functional
mobility.
• Adapted to physical and psychological changes
imposed by the rheumatic disease.

17. DISCHARGE PLANING
• Disorder education. The patient and family must be able to
explain the nature of the disease and principles of disease
management.
• Medications. The patient or caregiver must be able to
describe the medication regimen (name of
medications, dosage, schedule pf administration,
precautions, potential side effects, and desired effects.
• Pain management. The patient must be able to describe
and demonstrate use of pain management techniques.
• Independence. The patient must be able to demonstrate
ability to perform self-care activities independently or with
assistive devices.

18. REFRENCES
• https://www.mayoclinic.org/diseases-
conditions/rheumatoid-arthritis/diagnosis-
treatment
• https://nurseslabs.com/rheumatoid-arthritis/
• Factsheets/DorMusculoEsqueletica/en/Rheum
atidArthritis

19. THANKS