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70 Year-old female patient with rheumatoid arthritis (RA) in the hospital,…

- - - - Develop plan with OT to help client with at-home and in-community mobility
      - Schedule regular meetings for clients to meet with OT to discuss accessibility as their needs change over time.
      - Following mobility assessment, collaborate with OT if client is in need of special cutlery or other aides in order for the client to feed themselves
    - - Collaborate with PT to assess musculoskeletal function
      - Develop moderate intensity exercise plan with PT and client
    - - Arrange for mental health support for the client when needed
      - Share resources to improve client's access to social events and/or community support
    - - Collaborate with RD to ensure client is getting (and absorbing) adequate nutrition, especially iron.
      - Have RD make a nutrition plan with client if needed
    - - Collaborate with Recreation Therapist to make a plan for the client to participate in recreational activities with an emphasis on socializing with others
  - - - Discuss pain management with MRP if pain goals are not being met
- - - - Document appropriately, coordinate with MRP/PT/OT, educate family and client on fall prevention.
    - - Reassess frequently.
- - - - Assess client's joints for functional range of motion
        
        Document all affected joints and their loss of mobility and/or function.
      - Assess joints for inflammation, especially if/where client reports pain
      - Assess for deformity and subluxation,
        such as ulnar drift
    - - Even musculature bilaterally on visual assessment
      - Assess muscle atrophy, especially around joints affected by RA
      - Assess for contracture
      - Test and compare client's strength bilaterally
    - - Check for pressure injuries
    - - Low-grade fever is common in systemic RA
- - - - Family should monitor client's eating and encourage them to eat a well-balanced diet
      - Encourage the family to seek additional medical help if the client is not eating