Caring for Patients with Rheumatoid Arthritis Rheumatoid arthritis
Caring for Patients with Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an incurable autoimmune disease where the body’s immune system – which normally protects the body by attacking foreign substances such as bacteria and viruses – has an abnormal response and mistakenly attacks the joints instead (Crawford ; Harris, 2015). Crawford and Harris (2015) continue to explain that this attack on the joints creates inflammation that causes the tissue inside the synovial joint to “undergo reactive hyperplasia (p.32).” This thickening of the joint results in edema and pain in and around the joints. If inflammation goes unchecked, it can worsen and end up damaging the cartilage as well as the bones themselves leading to reduced mobility (Crawford ; Harris, 2015). Joints can eventually become deformed and complete loss of function can occur. According to Durham (2015), RA affects around 1% of people worldwide and the debilitating signs and symptoms that come along with RA usually impact the person’s quality of life in a negative way.
This paper hopes to explore ways for nurses to improve quality of life for those diagnosed with rheumatoid arthritis. Important factors include understanding rheumatoid arthritis to help provide an early diagnosis and patient education as well as implementing personalized and effective nursing care plans that include aggressive treatments and the encouragement of patient self care.
Understanding Rheumatoid Arthritis
Although the pathophysiologic changes that occur with RA are understood, the exact cause of RA has yet to be determined (Crawford & Harris, 2015). It is believed that the development of the disease is due in part to having a family history of RA paired with an activation, or trigger, of the immune system; however no particular pathogen has been identified as the actual trigger (Durham, Fowler, Donato, Smith, & Jensen, 2015). The signs and symptoms for RA can be gradual and vague, making it difficult to differentiate from other disorders such as osteoarthritis, gout, or fibromyalgia (Durham et al., 2015). Since RA can lead to irreversible joint damage if left untreated, Durham (2015) emphasizes that “early detection can facilitate prompt treatment and thus, can improve the chances to minimize joint destruction, obtain adequate pain relief, and achieve clinical remission (p 38).”
Importance of Early Detection and Diagnosis
Given that it is difficult to differentiate RA from other inflammatory disorders, it is necessary to obtain both subjective and objective data along with lab tests to provide a diagnosis (Crawford & Harris, 2015). Lab results include assays for rheumatoid factor (RF),
Early and effective disease modification and pain management can reduce the risk of long-term disability and improve the patient’s overall quality of life (Durham et al., 2015). The earlier the intervention, the better the outcome. Durham (2015) explains that most of the deterioration of the joint that causes the debilitating effects of RA occurs within the first 2 years of diagnosis. It is important to being aggressive treatment as soon as possible, preferably in the first few months of the onset of symptoms. Doing so not only can alleviate some of the symptoms of RA be alleviated, but the progression of the disease can be slowed down (Crawford ; Harris, 2015)
Aggressive Treatments
Aggressive treatment includes DMARDs, which stands for disease-modifying anti-rheumatic drugs. These types of drugs are known to be the best known therapy and go to drugs for the first-line of treatment.
