Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • Verbalizes increased comfort, pain relief, and decreased fatigue • Demonstrates adequate mobility • Patient remains free from injury due to Reynaud’s phenomenon • Demonstrates ability to perform self-care Juvenile Rheumatoid/Idiopathic Arthritis This type of arthritis is seen in children under the age of 18. The three manifestations are polyarticular, systemic, and pauciarticular. The disease is chronic and can affect any joint in the body. It is characterized by general body symptoms, fever, swelling, pain, inflammation, mouth ulcers, and some children may experience heart (pericarditis) and eye disease (iridocyclitis). Juvenile rheumatoid arthritis can be caused by an allergic reaction, virus, or systemic autoimmune disease. Most often the body’s immune response is set off by stress, infection, or injury. Children who suffer from JRA may outgrow the condition by mid-teens with proper treatment, but those who do not go into remission may go on to develop adult rheumatoid arthritis. Signs and symptoms of juvenile rheumatoid arthritis: • Joint pain • Swelling in one or more joints • Fever • Mouth ulcers • Elevated sedimentation rate • Eye redness/vision changes • Enlarged lymph nodes • Limping (first sign of the disease) • Fatigue • Morning stiffness • Joint warmth • Crepitus in joints • Positive ANA/RF • Immobility • Palpitations Nursing assessment for juvenile rheumatoid arthritis: • Thorough patient and family medical history: recent infections, medications, and family history of autoimmune disease • Inquire about pain using faces scale, location, duration, andseverity • Check vital signs: temperature may be elevated to 98.9 to 99.9during flares • Visualize joints for deformity, swelling, crepitus, and range ofmotion • Review laboratory and radiology reports: o Erythrocyte sedimentation rate (ESR): Will be elevated over 20 o CBC: Increased neutrophils and platelets o C-Reactive protein: Positive or increased o Anti-nuclear antibodies (ANA) and rheumatoid Ffactor (RF): Not always positive o Serum protein: Will be increased

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