Rheumatoid Arthritis Nursing NCLEX Lecture: Symptoms, Treatment, Interventions, Medications

Summary

This video provides an in-depth review of Rheumatoid Arthritis (RA), an autoimmune condition where the immune system attacks the joints, causing inflammation and potential joint damage. The video explains the stages of RA, from synovitis to ankylosis, highlighting its systemic effects and the importance of early diagnosis and intervention. Treatment options include NSAIDs, corticosteroids, DMARDs, and biologics, each with specific risks and benefits. The video also covers nursing interventions to manage pain, support joint health, and prevent complications like deformities. Viewers are encouraged to take a quiz to test their knowledge on RA.

Takeaways

• 😀 RA is an autoimmune disorder that primarily targets joints, leading to inflammation, pain, and potential long-term damage.
• 😀 Common symptoms of RA include morning stiffness, bilateral joint involvement, tenderness, and swelling of the joints.
• 😀 RA is characterized by systemic symptoms like fever, fatigue, and anemia, which affect the whole body.
• 😀 Diagnostic tests for RA include rheumatoid factor, ESR, CRP, and x-rays, which help in identifying inflammation and joint damage.
• 😀 NSAIDs (e.g., ibuprofen) are used to reduce inflammation and alleviate pain but can cause gastrointestinal upset, so they should be taken with food.
• 😀 Corticosteroids (e.g., prednisone, methotrexate) help reduce inflammation but can lead to side effects like elevated blood sugar, skin thinning, and increased infection risk.
• 😀 Disease-Modifying Antirheumatic Drugs (DMARDs) like hydroxychloroquine and methotrexate help slow the progression of RA by suppressing the immune system.
• 😀 Biologic DMARDs, such as adalimumab, target specific components of the immune system and are used for severe RA cases but carry a risk of rare cancers and infections.
• 😀 Patients on immunosuppressive drugs should avoid live vaccines and be cautious about infection risks, particularly during flu or pneumonia season.
• 😀 Nursing interventions for RA include pain management, joint support, exercise, and patient education on disease progression and medication side effects.

Q & A

What is Rheumatoid Arthritis (RA) and how does it affect the body?

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder where the body's immune system attacks the synovium, which is the membrane lining the joints. This causes inflammation, joint damage, and can lead to loss of mobility. RA can also have systemic effects, impacting organs like the skin, lungs, and heart.

What are the primary symptoms of Rheumatoid Arthritis?

The primary symptoms of RA include symmetrical joint pain, stiffness lasting over 30 minutes in the morning, swollen and tender joints, fatigue, fever, and weight loss. These symptoms are caused by inflammation and the body’s immune response.

How does RA differ from osteoarthritis?

RA is an autoimmune condition that causes joint inflammation and can affect multiple joints symmetrically, whereas osteoarthritis is a degenerative joint disease primarily caused by wear and tear, and often affects individual joints asymmetrically.

What are the main classes of drugs used in the treatment of RA?

The main classes of drugs used in RA treatment include NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), corticosteroids, and DMARDs (Disease-Modifying Anti-Rheumatic Drugs). NSAIDs help manage pain and inflammation, corticosteroids reduce inflammation, and DMARDs suppress the immune system to slow disease progression.

What are the potential side effects of corticosteroids in RA patients?

Corticosteroids can cause several side effects including increased blood sugar (which can affect diabetic patients), thinning of the skin, easy bruising, and a suppressed immune system that can lead to higher infection risk.

What are the different types of DMARDs and how do they work?

DMARDs include traditional drugs like methotrexate and hydroxychloroquine, and biologic DMARDs like adalimumab. These drugs suppress the immune system, preventing the body’s white blood cells from attacking the joints and slowing down the progression of the disease.

Why are biologic DMARDs used in severe cases of RA?

Biologic DMARDs are genetically engineered drugs used in severe RA cases because they are highly effective at targeting specific parts of the immune system that cause joint damage, helping to slow or stop disease progression in patients who have not responded to traditional DMARDs.

What precautions should be taken when using biologic DMARDs?

Patients using biologic DMARDs need to be cautious about infections, as these drugs suppress the immune system. They should avoid live vaccines, ensure they regularly attend blood work appointments to monitor white blood cell count, and avoid exposure to sick individuals.

What role does patient education play in managing RA?

Patient education is crucial in RA management. Patients need to understand their disease, how to take medications correctly, and the importance of lifestyle changes. Educating them about avoiding triggers, managing flare-ups, and protecting their joints through exercise and rest is key to preventing further damage.

How does RA affect a patient's mental health, and what interventions are necessary?

RA can negatively impact a patient’s mental health, causing stress, depression, and anxiety due to chronic pain and disability. Interventions include offering emotional support, providing mental health resources, and addressing self-esteem and coping strategies during patient education.