Signs and symptoms of rheumatoid arthritis may include:
- Tender, warm, swollen joints
- Morning stiffness that may last for hours
- Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
- Fatigue, fever and weight loss
Nursing Diagnosis and Nursing Intervention for Rheumatoid Arthritis
Pain (Acute / Chronic)
- Tissue distension by fluid accumulation / inflammation
- Joint destruction.
Can be evidenced by :
- Complaints of pain, discomfort, fatigue.
- Self-focusing / narrowing of focus
- Behavior distraction / autonomic response
- Behavior that is carefully / protect
Expected Result / criteria for evaluation of patients will :
- Showed pain relief / control
- Looks relaxed, sleep / rest and participate in activities according to ability.
- Follow the program prescribed pharmacological
- Combining the skills of relaxation and entertainment activities into a program of pain control.
Nursing Interventions and Rational for Rheumatoid Arthritis :
- Assess complaints of pain, note the location and intensity (scale 0-10). Note factors that accelerate and signs of pain non-verbal.
Rational: To assist in determining the need for pain management and program effectiveness.
- Give a hard mattress, small pillows, bed linen Elevate as needed.
Rational: A soft mattress, large pillows, will prevent the maintenance of proper body alignment, placing stress on joints that hurt. Elevation of bed linen lowering the pressure in the inflamed joints / pain.
- Place / monitor the use of pillows, sandbags, splint, brace.
Rational: Resting sore joints and maintain a neutral position. Use of the brace can reduce pain and can reduce damage to the joints.
- Suggest to frequently change positions, Help to move in bed, prop a pain in the joints above and below, avoid jerky movements.
Rationale: Prevent the occurrence of general fatigue and joint stiffness. Stabilize the joint, reducing the movement / pain in the joints.
- Instruct the patient to a warm bath or shower at the time awake and / or at bedtime. Provide a warm washcloth to compress the joints are sick several times a day. Monitor water temperature, water bath, and so on.
Rational: Heat increases muscle relaxation, and mobility, reduce pain and release the stiffness in the morning. Sensitivity to heat can be removed and dermal wound can be healed.
- Give a massage.
Rationale: Increase relaxation / pain relief.
- Encourage the use of stress management techniques, such as progressive relaxation, therapeutic touch, biofeed back, visualization, imagination guidelines, self hypnosis, and breath control.
Rationale: Increase relaxation, giving a sense of control and possibly enhance the coping abilities.
- Engage in activities of entertainment that is appropriate for individual situations.
Rational: To focus attention again, provide stimulation, and increased self-confidence and feeling healthy.
- Give the drug prior to activity / exercise that is planned as directed.
Rationale: Increase relaxation, reduce muscle tension / spasm, making it easier to participate in therapy.
- Collaboration: Give medicines as directed.
Rational: As an anti-inflammatory and mild analgesic effect in reducing stiffness and improving mobility.
- Give ice-cold compress if needed
Rational: The cold can relieve pain and swelling during the acute period.