Rheumatoid Diseases Osteoarthritis Rheumatoid Arthritis Systemic Lupus Erythematosis Scleroderma Osteoarthritis Definition: *wear and tear, progressive, non-systemic, Degenerative Joint Disease (DJD) Pathophysiology Note top slide only
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Systemic Lupus Erythematosis
Identify which joints are primarily affected with osteoarthritis.
What factors contribute to the development of osteoarthritis?
Cartilage softens, pits, frays
Cartilage thinner, bone ends hypertrophy, bone spurs develop and fissures form
Secondary inflammation of synovial membrane; tissue and cartilage destruction; late ankylosis
Normal Knee structure
Moderately advanced osteoarthritis
Onset of pain is insidious, individual is healthy!
Pain is aching in nature; relieved by rest!.
Local signs and symptoms: swelling, crepitation of joint and joint instability, asymmetrical joint involvement
Carpometacarpocarpal joint of thumb with subluxation of the first MCP
Diagnostic Tests experience
Late joint changes, boney sclerosis, spur formation
Synovial fluid inc., minimal inflammation
Interventions determined by complications
Medications (no systemic treatment with steroids)
Dietary to dec. wt.
Surgical Intervention (joint replacement)
Chronic systemic, inflammatory disease characterized by recurrent inflammation of diarthroidal joints and related structures.
*Body parts affected, systemic, small joints, symmetrical
Females, age 20-30; 3-1 ratio
Cause “wear and tear”, weight
Non-systemic, weight bearing joints
Middle-aged and elderly, males 2-1 affected
Fatigue, weakness, pain experience
IgG/RF (HLA)= antigen-antibody complex
Precipitates in synovial fluid
Early Pannus experience
Granulation, inflammation at synovial membrane, invades joint, softens and destroys cartilageJoints changes with RA
Bilateral, symmetrical, PIP’s, MCP’s experience
Swan neck, boutonniere deformity
Pes plano valgus
Prominent metatarsal heads
Hammer toesJoint Changes
Deformities that may occur with RA
Swan neck deformity
Mutlans deformity (rapidly progressing RA) experience
Hammer toes experience
Subcutaneous nodules (disappear and appear without warning)
Nursing Diagnosis experience
Joint Protection: Do’s and Don’t’s experience
Chronic multisystem disease involving vascular and connective tissue
Types: Discoid, SLE experience
Periods remission and exacerbation
Low grade fever
Digestive,anemiaCharacteristics of SLE
Characteristic butterfly rash associated with SLE, especially discoid lupus erythematous
SLE characterized by periods of especially discoid lupus erythematousremission and exacerbation. Stimulated by sunlight, stress, pregnancy, infections like strep and some drugs. Some drugs like apresoline, pronestyl, dilantin, tetracycline, phenobard may cause a lupus-like reaction which disappears when drug is stopped.
LE cell especially discoid lupus erythematous
Criteria to Dx.
malar, discoid rash
DNA, ANADiagnostic Tests
Nursing diagnosis especially discoid lupus erythematous
Goal to control inflammation
Monitor/manage to prevent complicationsManagement SLE
Typical “hide-bound” face of person with scleroderma especially discoid lupus erythematous
Tissue hardens; claw-like fingers; fibrosis
More on CREST
R/O autoimmune disease especially discoid lupus erythematous
Radiological: pulmonary fibrosis, bone resorption, subcutaneous calcification, distal esophageal hypomotility
What are the KEY components of care for the individual with Scleroderma?Diagnosis/Treatment Scleroderma
Definitions; polyarteritis of spine especially discoid lupus erythematous
Affects mostly men
Associated with HLA positive antigen
Signs and symptoms
Morning backache, flexion of spine, decreased chest expansion
Nursing DiagnosisAnkylosing Spondylitis
Ankylosing Spondylitis especially discoid lupus erythematous
Inflammation of spine; later spine ossification
Oh my back hurts!
Identify a PRIORITY nursing concern related to ankylosing spondylitis
Reiter’s Syndrome spondylitis
Reactive arthritis associated with enteric disease
Caused by spirochete, borrelia burgdorferi
Inflammation, necrosis of walls small to medium sized arteries
Affects skin and voluntary muscles
JRAOther Collagen Diseases