Essay example: Joint Manifestations of Rheumatoid Arthritis

The blood has to go through tests because patients with rheumatoid arthritis usually have increased Erythrocyte Sedimentation Rates (ESR) and C - reactive protein (CRP). The presence of these elements shows that the patient has a process of inflammation going on in their body. Many other blood tests can be carried out to look out for Anti-cyclic Citrullinated Peptide antibodies and rheumatoid factor. Some imaging tests can also be performed to such patients to check on how the rheumatoid inflammations are progressing in their joints over periods. Such include X-rays, MRI, and ultrasounds (Churov et al., 2015). Ultrasounds and MRI enable doctors to know how severe rheumatoid arthritis is in their patients.

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Appropriate Treatments

There is no permanent cure for rheumatoid arthritis, but these symptoms can fade away when a patient begins treatment early enough with Disease-Modifying Antirheumatic Drugs (DMARDs) which are powerful medication against rheumatoid arthritis. The purposes for treating this ailment is to relieve the symptoms, avoid the permanent damage to joints, stop swellings and improve the physical operations of a patient. Some of these treatments include occupational or physical therapies, joint surgeries for correcting impairments, medications, and frequent exercises (Pedraz-Marcos et al., 2017).

Medications

The type of drugs administered to a patient who has rheumatoid arthritis depends on how severe the symptoms are and how long the patient has had this ailment. These medications include steroids. Corticosteroids including prednisone deal with pain and inflammation to reduce the rate of damaging joints (Churov et al., 2015). However, they may have side effects that include gaining weight, diabetes, and bone thinning. Doctors usually prescribe these medications for relieving short-term symptoms with the aim of reducing the intake of these medications.

Biological agents are also given to deal with the patient's immune systems that lead to swellings and damages of joints and tissues. They include certolizumab, infliximab, tocilizumab among many others. However, they increase the risk of patients getting infections and work best when combined with DMARD that are not biological like methotrexate. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be used to minimize discomfort caused by rheumatoid arthritis and also reduces the swellings. Patients can buy some over the counter, but some are so strong and only requires a doctor's prescription. They, however, have side effects like damages to the liver and kidney, irritations of the stomach and problems of the heart among many others (Churov et al., 2015). The last but not least form of medication is the DMARDs that reduce the rate at which rheumatoid arthritis grows to minimize the chances of joints and tissues getting damaged permanently. They include sulfasalazine, leflunomide among many others.

Nursing Assessments

As a registered nurse, a patient presenting themselves with symptoms relating to rheumatoid arthritis has to get an assessment concerning how long the symptoms have lasted. If they have been there for a long time, like over four months, then this might rule out the possibilities of Lyme diseases or viral arthritis. The patient has to go through checks for inflammations in joints, both on the hands and knees. The nurse may also look to find if the patient's physical appearances look good and whether they can carry out their normal activities as usual. Depending on how a patient presents themselves and the different symptoms will guide the nurse on what to look out for to find out whether the symptoms relate to those of rheumatoid arthritis or not (Hendrikx et al., 2016).

Expected Patient's Presentation

For a registered nurse to be able to judge whether a patient may have rheumatoid arthritis, the patient presentation includes them complaining about not being able to perform their daily activities like walking, typing or even using a toilet among other activities that involve movements of joints (Ledingham et al., 2016). A patient may present themselves with weight losses, fatigue, and depression and in rare cases; the presentations of extraarticular nodules may show.

Evaluation

For a nurse to determine whether the care plan worked, they have to find out whether the condition of the patient has improved, that is if the patient is no longer experiencing pain or joint stiffness in the morning. If so then the plan would have succeeded (Garner, 2017). If the patient experiences reduced joint stiffness and reduced pain, then it means that he took the medications according to the stipulations, he had the medical document presented to his employer requesting for some periods of rest and also engaged him in less strenuous activities. Contrary to these, then the patient never made use of the nursing interventions to help in achieving his goals.

Conclusion

Rheumatoid arthritis is a disease that is treated with care, can help lessen the symptoms that come with it. Nurses have to assess a patient, diagnose, and give medications according to the extent of the condition so that patients may be relieved. A nursing care plan is an excellent form of relationship building between a caregiver and a patient suffering from this ailment because it gives an opportunity for the nurse to offer their services appropriately to the patients and the patients to feel relief from their sufferings. Successful care plans ensure patients get relief so that nurses can be sure that the patient keenly takes in the instructions as they are supposed to. A good nursing plan should include what the diagnosis of the nurse is, their SMART goals based on the determination and then interventions that nurses make so that the patient meets these goals set on their diagnosis. The nurse has to evaluate a patient then determine the success of the whole plan.

References

Allen, P. (2016). Joint Manifestations of Rheumatoid Arthritis. Retrieved from https://digitalcommons.otterbein.edu/cgi/viewcontent.cgi?referer=https://scholar.google.com/&httpsredir=1&article=1195&context=stu_msn

Churov, A. V., Oleinik, E. K., & Knip, M. (2015). MicroRNAs in rheumatoid arthritis: altered expression and diagnostic potential. Autoimmunity reviews, 14(11), 1029-1037. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1568997215001548

Garner, S., Lopatina, E., Rankin, J. A., & Marshall, D. A. (2017). Nurse-led care for patients with Rheumatoid Arthritis: a Systematic Review of the effect on Quality of Care. The Journal of Rheumatology, jrheum-160535. Retrieved from http://www.jrheum.org/content/early/2017/02/09/jrheum.160535.abstract

Hendrikx, J., de Jonge, M. J., Fransen, J., Kievit, W., & van Riel, P. L. (2016). A systematic review of patient-reported outcome measures (PROMs) for assessing disease activity in rheumatoid arthritis. RMD open, 2(2), e000202. Retrieved from https://rmdopen.bmj.com/content/2/2/e000202?utm_campaign=rmd&utm_term=1-A&utm_content=consumer&utm_medium=cpc&utm_source=trendmd