Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Signs and symptoms of rheumatoid arthritis: • Fever • Fatigue • Nodules under skin • Joint pain • Spongy/boggy joints Signs and symptoms of systemic lupus erythematosus: • Reynaud’s phenomenon (blue fingers/toes) • Chest pain • Cough • Skin rashes • Butterfly rash across nose • Mouth ulcers • Fevers • Fatigue/malaise • Weight loss/gain • • • • •

Morning stiffness Deformities Weight loss Anemia

Joint pain/morning stiffness/arthralgia • Lesions from exposure to sunlight • Papular erythematosus rash to hands • Lymphadenopathy • Pericarditis • Pleuritis • Nephritis • CNS symptoms: psychosis and seizures • Abdominal symptoms: nausea and vomiting

Nursing assessment for rheumatoid arthritis: • Take vital signs: temperature will be slightly elevated 98.9 to 99.9 and patient will complain of chronic fevers, usually towards evening time • Chart fatigue and pain; have patient keep a diary of symptoms over 30days • Family history of auto-immune disease/arthritis • Assess joints for fluid, crepitus, and boggy feeling • Assess for range of motion • Review laboratory reports: o ESR (erythrocyte sedimentation rate): Will be elevated; 20-40 is mild inflammation; 40-70 is moderate inflammation; 70-150 is severe inflammation o CRP (C - reactive protein) o RF (rheumatoid factor): Not always positive, 20% of RA patients show negative o ANA: Antinuclear antibodies; almost always 95% positive but not in everyone o CBC: Red blood cells will be decreased in RA o Synovial fluid analysis: Fluid will show RF antibodies and WBCs o X-ray: Can show joint inflammation

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