Podcast
Questions and Answers
What is the goal of treatment at all phases of the RA disease process?
What is the goal of treatment at all phases of the RA disease process?
- To only decrease joint pain and swelling
- To minimize the need for disability aids
- To achieve complete elimination of joint deformity
- To decrease joint pain and swelling, achieve clinical remission, decrease the likelihood of joint deformity, and minimize disability (correct)
What is the recommended initial treatment approach for early Rheumatoid Arthritis?
What is the recommended initial treatment approach for early Rheumatoid Arthritis?
- Use corticosteroids as the first-line treatment
- Start with biologic DMARDs only
- Delay treatment until the disease progresses
- Begin with either a nonbiologic or biologic DMARD (correct)
Which medication is the preferred nonbiologic DMARD for RA treatment?
Which medication is the preferred nonbiologic DMARD for RA treatment?
- Hydroxychloroquine
- Leflunomide
- Methotrexate (correct)
- Sulfasalazine
What routine testing is recommended for patients using DMARD therapy?
What routine testing is recommended for patients using DMARD therapy?
When should treatment with DMARD therapy begin for Rheumatoid Arthritis?
When should treatment with DMARD therapy begin for Rheumatoid Arthritis?
What is the goal of using DMARD therapy in RA?
What is the goal of using DMARD therapy in RA?
What is a crucial aspect of treating rheumatoid arthritis (RA) according to the text?
What is a crucial aspect of treating rheumatoid arthritis (RA) according to the text?
What should be addressed before initiating patient education for RA?
What should be addressed before initiating patient education for RA?
What is considered safe and potentially beneficial for patients with RA?
What is considered safe and potentially beneficial for patients with RA?
What should be used sparingly and with caution to avoid skin irritation in patients with RA?
What should be used sparingly and with caution to avoid skin irritation in patients with RA?
When might referral for home care be necessary for patients with RA?
When might referral for home care be necessary for patients with RA?
What can home health nurses do for patients with RA?
What can home health nurses do for patients with RA?
Which type of drugs are engineered to target prominent proinflammatory mediators in RA, such as TNF-α, B cells, T cells, IL-1, and IL-6?
Which type of drugs are engineered to target prominent proinflammatory mediators in RA, such as TNF-α, B cells, T cells, IL-1, and IL-6?
Which type of drugs work more quickly than nonbiologic DMARDs and show greater delay in radiologic disease progression?
Which type of drugs work more quickly than nonbiologic DMARDs and show greater delay in radiologic disease progression?
What are corticosteroids recommended as in early treatment of RA?
What are corticosteroids recommended as in early treatment of RA?
What do NSAIDs and COX-2 enzyme blockers primarily provide relief for in RA?
What do NSAIDs and COX-2 enzyme blockers primarily provide relief for in RA?
Why are opioid analgesic agents avoided in RA treatment?
Why are opioid analgesic agents avoided in RA treatment?
What is increasing in patients with RA and adversely affecting disease progression, function, and quality of life?
What is increasing in patients with RA and adversely affecting disease progression, function, and quality of life?
What should a dietician emphasize when counseling patients with rheumatoid arthritis?
What should a dietician emphasize when counseling patients with rheumatoid arthritis?
What is a key nursing intervention for managing fatigue in patients with rheumatoid arthritis?
What is a key nursing intervention for managing fatigue in patients with rheumatoid arthritis?
What is encouraged to promote coping in patients with rheumatoid arthritis?
What is encouraged to promote coping in patients with rheumatoid arthritis?
What may improve mobility in patients with rheumatoid arthritis?
What may improve mobility in patients with rheumatoid arthritis?
What is a key aspect of nursing care for rheumatoid arthritis?
What is a key aspect of nursing care for rheumatoid arthritis?
What may lead to a decrease in personal safety in patients with rheumatoid arthritis?
What may lead to a decrease in personal safety in patients with rheumatoid arthritis?
What is a nursing intervention for patients with rheumatoid arthritis (RA) to achieve the goal of performing self-care activities independently?
What is a nursing intervention for patients with rheumatoid arthritis (RA) to achieve the goal of performing self-care activities independently?
What is a nursing diagnosis for RA patients associated with physical and psychological changes and dependency imposed by chronic illness?
What is a nursing diagnosis for RA patients associated with physical and psychological changes and dependency imposed by chronic illness?
What is a collaborative problem for RA patients related to the effects of medications?
What is a collaborative problem for RA patients related to the effects of medications?
What is a common comorbid condition for RA patients that can lead to complications?
What is a common comorbid condition for RA patients that can lead to complications?
What is essential in nursing care of RA patients to enable them to maintain independence and use adaptive devices correctly?
What is essential in nursing care of RA patients to enable them to maintain independence and use adaptive devices correctly?
What is a nursing intervention for RA patients to manage symptoms and enlist support for difficulty coping associated with actual or perceived lifestyle or role changes?
What is a nursing intervention for RA patients to manage symptoms and enlist support for difficulty coping associated with actual or perceived lifestyle or role changes?
What is a key nursing intervention for managing fatigue in patients with rheumatoid arthritis?
What is a key nursing intervention for managing fatigue in patients with rheumatoid arthritis?
What is a nursing intervention for RA patients to achieve the goal of performing self-care activities independently?
What is a nursing intervention for RA patients to achieve the goal of performing self-care activities independently?
What is a common comorbid condition for RA patients that can lead to complications?
What is a common comorbid condition for RA patients that can lead to complications?
What is a collaborative problem for RA patients related to the effects of medications?
What is a collaborative problem for RA patients related to the effects of medications?
What may lead to a decrease in personal safety in patients with rheumatoid arthritis?
What may lead to a decrease in personal safety in patients with rheumatoid arthritis?
What is essential in nursing care of RA patients to enable them to maintain independence and use adaptive devices correctly?
What is essential in nursing care of RA patients to enable them to maintain independence and use adaptive devices correctly?
What is a nursing intervention for disturbed body image associated with physical and psychological changes in RA patients?
What is a nursing intervention for disturbed body image associated with physical and psychological changes in RA patients?
What is a common comorbid condition for RA patients that can lead to complications?
What is a common comorbid condition for RA patients that can lead to complications?
What is the primary goal of nursing interventions for RA patients experiencing difficulty coping with lifestyle or role changes?
What is the primary goal of nursing interventions for RA patients experiencing difficulty coping with lifestyle or role changes?
What is a collaborative problem for RA patients related to the effects of medications?
What is a collaborative problem for RA patients related to the effects of medications?
What is an essential aspect of patient education in nursing care for RA patients?
What is an essential aspect of patient education in nursing care for RA patients?
What is the goal of nursing interventions for RA patients with self-care deficits and factors that interfere with self-care activities?
What is the goal of nursing interventions for RA patients with self-care deficits and factors that interfere with self-care activities?
Study Notes
Rheumatoid Arthritis Treatment Options and Considerations
- Biologic DMARDs are engineered to target prominent proinflammatory mediators in RA, such as TNF-α, B cells, T cells, IL-1, and IL-6.
- Biologic DMARDs work more quickly than nonbiologic DMARDs and show greater delay in radiologic disease progression.
- They are more expensive and have fewer years of usage with the RA population, thus reserved for patients with persistent moderate to severe RA who have not responded adequately to synthetic DMARDs.
- After initiating treatment with a DMARD, patients generally report a beneficial effect within 6 weeks and tolerate the medication relatively well.
- Corticosteroids are recommended as a "bridge" in early treatment but not for long-term therapy due to side effects.
- JAK inhibitors, a newer class of drugs, inhibit cytokine production and decrease the immune response, and are used in combination with methotrexate or other nonbiologic DMARDs.
- NSAIDs and COX-2 enzyme blockers are used for pain and inflammation relief, with caution due to the possibility of gastric ulcers.
- NSAIDs do not prevent erosions or alter disease progression and are useful only for symptom relief.
- Opioid analgesic agents are avoided due to the potential for continuing need for pain relief.
- Nonpharmacologic pain management techniques are taught, and a formal program with occupational and physical therapy is prescribed for patients with established RA.
- The prevalence of obesity is increasing in patients with RA, adversely affecting disease progression, function, and quality of life.
- Certain medications used in RA treatment, such as oral corticosteroids, stimulate the appetite and may lead to weight gain when combined with decreased activity.
Nursing Interventions for Rheumatoid Arthritis Patients
- Nursing interventions for patients with rheumatoid arthritis (RA) include allowing ample time for activity, providing rest periods, and reinforcing principles of pacing and work simplification.
- The goal is for patients to perform self-care activities independently or with the use of resources.
- Nursing interventions to achieve this goal include assisting the patient to identify self-care deficits and factors that interfere with self-care activities, providing appropriate assistive devices, and allowing the patient to control the timing of self-care activities.
- Another nursing diagnosis for RA patients is disturbed body image associated with physical and psychological changes and dependency imposed by chronic illness.
- Nursing interventions for this diagnosis involve identifying areas of life affected by the disease, assisting in identifying past coping mechanisms, and developing a plan for managing symptoms and enlisting support.
- Difficulty coping associated with actual or perceived lifestyle or role changes is another nursing diagnosis for RA patients.
- Nursing interventions for this diagnosis include identifying areas of life affected by the disease, assisting in identifying past and effective coping mechanisms, and developing a plan for managing symptoms and enlisting support.
- Collaboration with healthcare agencies is important when individuals have attained a maximum level of self-care yet still have deficits, especially regarding safety.
- Complications secondary to effects of medications are a collaborative problem for RA patients, and the goal is the absence or resolution of complications.
- Nursing interventions for this problem involve performing periodic clinical assessment and laboratory evaluation, providing education about correct self-administration and potential side effects, counseling regarding methods to reduce side effects, and administering medications in modified doses as prescribed if complications occur.
- RA patients commonly have comorbid conditions such as cardiovascular disease, which can lead to complications. Up to 40% of patients diagnosed with RA may have cardiovascular disease as the primary cause of death.
- Patient education is essential in nursing care of RA patients to enable them to maintain independence, take medications accurately and safely, and use adaptive devices correctly.
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Description
Test your knowledge of nursing interventions for rheumatoid arthritis (RA) patients with this quiz. Explore topics such as self-care activities, coping mechanisms, collaboration with healthcare agencies, and managing complications of RA and comorbid conditions. This quiz will assess your understanding of providing holistic care for RA patients.