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    Rheumatoid Arthritis

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    Kim Gonzales
    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical joint involvement that is typically erosive and destructive. The hallmark feature is persistent symmetric polyarthritis or joint inflammation. The disease has an unknown etiology but is thought to involve genetic and autoimmune factors. The pathophysiology involves T cells and B lymphocytes activating macrophages and fibroblasts in the synovium, causing joint injury, pannus formation, and eventual joint destruction through enzymes and cytokines released. Clinical manifestations include arthritis with associated low fever, fatigue, and morning stiffness, as well as potential extra-articular features and complications affecting other organ systems. Diagnosis is based on symptoms and signs meeting certain criteria. Nursing diagnoses focus on managing pain, fatigue,

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    Rheumatoid Arthritis

    Uploaded by

    Kim Gonzales
    8K views19 pages
    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical joint involvement that is typically erosive and destructive. The hallmark feature is persistent symmetric polyarthritis or joint inflammation. The disease has an unknown etiology but is thought to involve genetic and autoimmune factors. The pathophysiology involves T cells and B lymphocytes activating macrophages and fibroblasts in the synovium, causing joint injury, pannus formation, and eventual joint destruction through enzymes and cytokines released. Clinical manifestations include arthritis with associated low fever, fatigue, and morning stiffness, as well as potential extra-articular features and complications affecting other organ systems. Diagnosis is based on symptoms and signs meeting certain criteria. Nursing diagnoses focus on managing pain, fatigue,

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    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical joint involvement that is typically erosive and destructive. The hallmark feature is persistent symmetric polyarthritis or joint inflammation. The disease has an unknown etiology but is thought to involve genetic and autoimmune factors. The pathophysiology involves T cells and B lymphocytes activating macrophages and fibroblasts in the synovium, causing joint injury, pannus formation, and eventual joint destruction through enzymes and cytokines released. Clinical manifestations include arthritis with associated low fever, fatigue, and morning stiffness, as well as potential extra-articular features and complications affecting other organ systems. Diagnosis is based on symptoms and signs meeting certain criteria. Nursing diagnoses focus on managing pain, fatigue,

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    8K views19 pages

    Rheumatoid Arthritis

    Uploaded by

    Kim Gonzales
    Rheumatoid arthritis is a chronic, systemic inflammatory disease characterized by symmetrical joint involvement that is typically erosive and destructive. The hallmark feature is persistent symmetric polyarthritis or joint inflammation. The disease has an unknown etiology but is thought to involve genetic and autoimmune factors. The pathophysiology involves T cells and B lymphocytes activating macrophages and fibroblasts in the synovium, causing joint injury, pannus formation, and eventual joint destruction through enzymes and cytokines released. Clinical manifestations include arthritis with associated low fever, fatigue, and morning stiffness, as well as potential extra-articular features and complications affecting other organ systems. Diagnosis is based on symptoms and signs meeting certain criteria. Nursing diagnoses focus on managing pain, fatigue,

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 19
    At a glance
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    Some key takeaways are that rheumatoid arthritis is a chronic inflammatory disease characterized by symmetrical joint involvement and persistent symmetric polyarthritis. It can be caused by genetic and environmental factors and has an autoimmune pathogenesis.

    Rheumatoid arthritis is thought to be caused by a combination of genetic and environmental factors. Genetic susceptibility involves certain HLA genes, and environmental triggers may include infectious agents that activate the immune system.

    Clinical manifestations of rheumatoid arthritis include morning stiffness, fatigue, joint warmth, swelling and pain. It can also involve extra-articular features such as inflammation of the salivary glands or lungs.

    RHEUMATOID ARTHRITIS

    What is RA?
    A Chronic,
    systemic inflammatory disease,
    characterised by symmetrical
    joint involvement which is
    typically erosive/destructive.
    hallmark feature: persistent
    symmetric polyarthritis (synovitis)
    Recap on the anatomy and physiology

    Function of JOINTS:

    • To allow articulation between two


    or more bones and
    • secondarily to permit movement
    by contraction of opposing
    muscles.
    Etiology

    •Unknown
    • Genetic
    • Autoimmune
    Pathophysiology
    Antigen –
    Environmental agent, infectious agent

    Genetic
    Susceptibility Activates CD4 helper
    HLA-DR4 T cells and probably
    HLA-DQ B lymphocytes
    HLA- DP
    Cytokines

    T cells stimulates
    Activates
    synovial macrophage
    B lymphocytes
    and fibroblast
    Pathophysiology
    T cells stimulates Activates B lymphocytes
    synovial macrophage
    and fibroblast
    Formation of
    rheumatoid
    RANKL factor
    Cytokines
    Activates Formation of
    osteoclast autoimmune complexes
    Fibroblast and probable deposition
    Chondrocytes in the joint
    Synovial cells
    Proliferation

    Enzymes release Joint injury


    (collagenase, streptomelysin, Pannus formation
    elactase, PGE2 and matrix Joint destruction
    metalloproteinases, others) Cartilage fibrosis
    Ankylosis
    INTERLEUKIN 1
    IL-1 is a potent stimulator of synoviocytes,
    chondrocytes and osteoblasts (Figure 1).
    IL-1 is a proinflammatory cytokine that amplifies
    and perpetuates the disease process in RA
    Clinical Manifestations
    1. arthritis
    Associated with
    •low fever
    •Fatigue
    •Morning stiffness
    •Joint soft, warm to
    touch
    Clinical Manifestations
    2. extra-articular features
    Clinical Manifestations
    3. Associated syndromes
    (possible complications)
    (a) Sjögren’s syndrome-salivary gland
    inflammation and keratoconjunctivitis
    (b) Felty’s syndrome-profound neutropenia,
    thrombocytopenia and splenomegaly
    (C) Pulmonary involvement-(pleuritis, interstitial
    pneumonitis, alveolitis and intrapulmonary
    rheumatoid nodules)
    (d) Cardiac involvement-pericarditis
    ns
    Diagnnostic criteria
    1. Morning stiffness lasting more than

    1 hour
    2. Arthritis of 3 or more joint areas.
    3. Arthritis of the hand joints
    4. Symetric arthritis
    5. Rheumatoid nodules over extensor
    surface or bony prominences.
    6. Serum rheumatoid factor.
    7. Radiologic changes.
    Types of JIA

    • oligoarticular JIA
    •Polyarticular JIA
    •Systemic JIA  
    Nursing Diagnosis:

    1. Acute Pain r/t inflammation & swelling


    2. Fatigue r/t increased metabolic rate
    3. Impaired physical mobility r/t decreased
    range of motion
    4. Disturbed body image r/t physical &
    psychological changes
    THANK
    YOU
    FOR
    LISTENING!

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