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Showing posts with label Rheumatoid Arthritis. Show all posts
Showing posts with label Rheumatoid Arthritis. Show all posts

Disturbed Body Image related to Rheumatoid Arthritis

Nursing Care Plan for Rheumatoid Arthritis

Rheumatoid arthritis is a disease which has long been known and spread throughout the world and involving all races and ethnic groups. Rheumatoid arthritis is often found in women, with the ratio of women to men is 3: 1. The tendency for women suffering from rheumatoid arthritis and remissions are common in women who are pregnant, this raises the suspicion of the presence of hormonal balance factor as one of the factors that affect this disease.

Most patients show symptoms of chronic intermittent disease, which if left untreated will cause damage to joints and progressive joint deformity that causes disability and even premature death.

Disturbed Body Image related to changes in the ability to perform the duties of a general, an increase in energy use, the imbalance of mobility.

Evidenced by:
  • Changes in the function of diseased body parts.
  • Focus on past strength and appearance.
  • Changes in lifestyle / physical ability to continue the role, job loss, dependence on the nearest person.
  • Changes in social engagement; a feeling of isolation. Feelings of helplessness, hopelessness.

Expected outcomes: The patient will :
  • Expressing increased confidence in the ability to cope with illness, changes in lifestyle, and possible limitations.
  • Develop a realistic plan for the future.

Intervention and Rationale

1. Encourage disclosure about the problem of the disease process, hope for the future.
R /: Give the opportunity to identify the fear / misconceptions and deal with it directly.

2. Discuss the meaning of loss / change in patients / people nearby. Ascertain how the patient's personal views on the functioning of day-to-day lifestyle.
R /: Identify how the disease affects self-perception and interaction with others will determine the need for intervention / counseling further.

3. Discuss the patient's perception of how the people closest to accept limitations.
R /: Gestures verbal / non-verbal people nearby can have a major influence on how the patient sees himself.

4. Acknowledge and accept the feelings of the bereaved, hostile, dependency.
R /: constant pain would be exhausting, and feelings of anger and hostility are common.

5. Pay attention to the behavior of withdrawing, denying use or too noticed a change.
R /: Can demonstrate emotional or maladaptive coping methods, requiring further intervention.

7. Involve patients in the treatment plan and schedule of activities.
R /: Increase the feeling of self-esteem, encourage independence, and encourage participation in therapy.

8. Assist in need of care required.
R /: Maintaining the appearance that can improve self-image.

9. Provide positive support when necessary.
R /: Allows patients to feel good about themselves. Reinforcing positive behavior. Increase confidence.

10. Collaboration: Refer to psychiatric counseling, eg specialist psychiatric nurse, psychologist.
R /: Patient / person nearby may need support for dealing with long-term process / incapacity.

11. Collaboration: Give medicines as directed, eg; antianxiety drugs and mood enhancer.
R /: It may be required at the time of the advent of the Great Depression, until the patient increases coping abilities more effectively.

Nursing Care Plan for Rheumatoid Arthritis


Nursing Care Plan for Rheumatoid Arthritis


Rheumatoid Arthritis (RA)

Rheumatoid Arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as in other organs in the body. Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly attacked by their own immune system. The immune system contains a complex organization of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.

While rheumatoid arthritis is a chronic illness, meaning it can last for years, patients may experience long periods without symptoms. However, rheumatoid arthritis is typically a progressive illness that has the potential to cause joint destruction and functional disability.
Source : medicinenet.com


Nursing Assessment for Rheumatoid Arthritis
  1. Activity / rest
    • Symptoms: Joint pain due to movement, tenderness, worsened by stress on the joints, stiffness in the morning, usually bilateral and symmetrical. Functional limitations that affect lifestyle, leisure, work, fatigue.
    • Signs: The limited range of motion, muscle atrophy, skin, contractor / abnormalities in the joints.
  2. Cardiovascular
    • Symptoms: Raynaud's phenomenon fingers / legs (eg intermittent pale, cyanosis, and redness on the fingers before the color returned to normal).
  3. Ego integrity
    • Symptoms: Acute stress factors / chronic: eg, financial, employment, disability, relationship factors, Decision and powerlessness (inability situation), Threats to the self-concept, body image, personal identity (such as dependence on others).
  4. Food / fluid
    • Symptoms: Inability to produce / consume food / fluids adequately: nausea, anorexia, difficulty in chewing.
    • Signs: Weight loss, Drought on mucous membranes.
  5. Hygiene
    • Symptoms: The difficulties to carry out personal care activities. Dependence on others.
  6. Neuro Sensory
    • Symptoms: numbness, tingling in hands and feet, loss of sensation in fingers. Symmetrical joint swelling.
  7. Pain / comfort
    • Symptoms: The acute phase of pain (may not be accompanied by soft tissue swelling in joints).
  8. Security
    • Symptoms: The skin shiny, taut, subcutaneous nodules, skin lesions, leg ulcers. The difficulty in handling light duty / household maintenance. Drought mild fever settled on the eyes and mucous membranes.
  9. Social interaction
    • Symptoms: Damage of social interaction with family / others; changing role; isolation.