Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide Nursing diagnosis for rheumatoid arthritis: • Pain related to inflammation, tissue damage, and joint immobility • Impaired mobility related to inflammation, secondary to pain and inflammation • Impaired skin integrity due to skin lesions • Body image disturbance related to changes in appearance • Fatigue related to immune system factors • Knowledge deficit related to disease process, medication, and self-management Nursing interventions for rheumatoid arthritis: • Patient teaching on disease management, medications, and lifestyle adjustments; patients need to be taught this is a lifelong disease that can be verymanageable • Give medications per MD order: o Salicylates and other anti-inflammatories: Helps decrease inflammation in the body and affected areas o Analgesics: Used for moderate to severe pain until anti-inflammatories are effective, which is about two weeks o Corticosteroids: Helps to reduce inflammation and slow the body’s immune response; primary drug used in the treatment of systemic lupus erythematosus o Biologic response modifiers: Decreases immune system response; warn patient risks of infection while on these medications • Teach patient to pace activities and take frequent rest periods • Monitor organ functions: kidneys, cardiac, and lungs • Teach pain control techniques: warm baths and ice to joints (use caution inReynaud’s) • Patients with lupus that have Reynaud’s should use caution with cold; wear gloves, keep hands and toes warm, use oven mitts to reach into freezer; if a Reynaud’s attack occurs, take immediate measures to re-warm the tissue and increase circulation • With lupus, provide good skin care and care of lesions with topical creams • Provide good oral care to patients with lupus oral ulcers • Teach lupus patients to avoid direct sunlight • Provide and encourage appropriate nutrition to avoid weight loss/gain • Encourage patient to avoid high stress situations; stress can precipitate a flare-up • Teach patient to perform active range-of-motion and gentle stretching exercises to increase mobility of joints • Encourage patient to join a community support group Expected outcomes for rheumatoid arthritis: • Verbalizes understanding of disease, medications, and management of disease long term

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