By Ann Schmidt Luggen Phd RN MSN CS BC-ARNP CNAA, Sue E. Meiner EdD APRN BC GNP
This concise consultant presents nurses with the instruments to aid older adults with arthritis in achieving the top attainable caliber of lifestyles. functional pointers on nursing administration, self care, and the significance of workout are a spotlight all through. half one provides particular arthritic stipulations in a uniform layout -- epidemiology, medical good points and administration, prognosis, pharmacotherapy, and nursing administration and interventions. half provides basic thoughts for dealing with arthritis, together with entire chapters on a ache administration, workout, and sufferer educating. Any nurse operating with the aged will locate this a primary source.
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Additional info for Care of Arthritis in the Older Adult (Springer Series on Geriatric Nursing)
Check also for subluxation, malalignment, metatarsal prolapse, hammer toes, lax collaterals, and bone on bone crepitus. Extra-articular assessment: Note the presence of nodules, digital infarcts, palmar erythema, Raynaud's phenomenon, episcleritis, peripheral neuropathy, and leg ulcers. USEFUL TOOLS FOR EVALUATION OF THE OLDER ADULT WITH RA (GORDON & HASTINGS, 1997) Stanford Health Assessment Questionnaire (HAQ) Functional Disability Index (EDI) Arthritis Impact Measurement Scales (AIMS) Self-report questionnaire for RA: The client checks the ability to do the following using the ranks of "without any difficulty" to "unable to do" (Gordon & Hastings, 1997) - Dressing, including tying shoelaces and doing buttons - Getting in and out of bed - Lifting a full cup to the mouth -Walking outdoors on flat ground -Washing and drying entire body -Bending down to pick up object on the floor -Turning faucets on and off - Getting in and out of a car Functional Capacity Classification (Gordon & Hastings, 1997) -Normal function without or despite symptoms -Some disability, but adequate for normal activity without special devices or assistance - Activities restricted, requiring special devices or personal assistance -Totally dependent Rheumatoid Arthritis 43 Laboratory Results Patients with RA may have normochromic-normocytic anemia, a mild leukocytosis, or thrombocytosis.
Arthritis and Rheumatism, 43, 568-575. S. (1999). Osteoarthritis. In L. R. Barker, J. R. Burton, P. D. ). Principles of ambulatory medicine (pp. 960-973). Baltimore: Williams & Wilkins. This page intentionally left blank 3 Rheumatoid Arthritis Ann Schmidt Luggen Rheumatoid arthritis (RA) is a systemic autoimmune disorder of unknown etiology with chronic, symmetric, erosive synovitis of peripheral joints. There are many extra-articular manifestations affecting mortality. The outcome has been poor because the disease usually starts in middle age and progresses with aging through joint destruction, deformity, and disability, despite appropriate therapy.
Drop attacks Changes in level of consciousness Peripheral paresthesias without signs of peripheral nerve disease or compression Sensation of the head falling forward on flexion of the cervical spine Loss of sphincter control Dysphagia, vertigo, convulsions, hemiplegia, dysarthria, nystagmus Involvement of the thoracic and lumbar spine is very uncommon in RA. However, compression fractures from the osteoporosis of Rheumatoid Arthritis 35 RA, aggravated by prednisone therapy, is common in the thoracic region.