• caused by mechanical wear & tear on joints
• affects the small finger joints, thumb and knees
• only affect 1 particular joint/ area of the body

• an autoimmune disease in which the body's own immune system attacks the body's joints
• affect joints all the over the body including hands, fingers, elbows, knees & hips
• affects multiple joints on both sides of the body

Rheumatoid factor: found in the blood of RA pts

• (CRP) C-reactive Protein: elevated due to inflammation. (measures the amount of a certain protein that is produced by the body due to inflammation)
• (ESR) Erythrocyte sedimentation rate: RBCs that settle faster than normal indicate inflammation in the body (measures how fast red blood cells settle in the test tube)
• Anti-CCP antibody: a specific marker for RA (detects antibodies to CCP: cyclic citrullinated peptide)
• (FBC) Full Blood Count: to identify anaemia
• Synovial Fluid examination: demonstrate changes associated with inflammation (increased turbidity- cloudiness, decreased viscosity, increased protein and WBC levels)
• X-ray of affected joints: space narrowing may be seen

1. Rest and exercise

• regular rest periods reduce manifestations
• splinting reduces unwanted motion
• low-impact aerobic exercises (swimming, walking)

2. Heat and Cold therapy

• used for analgesics and muscle-relaxing effects

3. Assistive Devices and splints

• splints provide joint rest, prevent contractures

4. Surgery

• for to has failed to prevent joint damage
• Arthrodesis (joint fusion): used to stabilize joints
• Arthroplasty (total joint replacement): for gross deformity and joint destruction

1. Monitor the level of pain and duration of morning stiffness.
   (R) Increased pain may necessitate changes in treatment plan.
2. Teach the use of heat and cold applications to provide pain relief.
   (R) Both heat and cold have analgesic effects and can help relieve associated muscle pain.
3. Teach about the use of prescribed anti-inflammatory medications and the relationship of pain and disease activity.
   (R) Anti-inflammatory agents reduce chemical mediators of inflammation and edema, relieving pain.

1. Demonstrating a caring, accepting attitude towards the patient. (R) Help pt accept the physical changes.
2. Encourage the pt to talk about the effects of the disease, both physical effects and effects on life roles.
   (R) Verbalization helps identify the feelings and gives the nurse the opportunity to validate证实 the feelings.
3. Encourage pt to maintain self-care and usual roles to the extent possible.
   (R) Independence enhances self-esteem.
4. Provide positive feedback for self-care activities and adaptive strategies.
   (R) This can encourage pt to continue adaptive measures and maintain independence.

1. Assess the pt's understanding of RA, its manifestations and effects, and the anticipated course of the disease. Reinforce and clarify information as needed.
   (R) Newly diagnosed pts need understandable information that is readily available to develop an understanding of their disease and its treatment.
2. Initiate an interprofessional care conference with the pt and family.
   (R) Pt and families need opportunities to discuss management strategies and their concerns and perceptions to develop a better understanding of interprofessional team member roles and services.
3. Refer the pt and family to community & social service agencies and local support groups.
   (R) These groups and agencies are valuable resources for the pt and family.
4. Encourage the pt and family members to discuss the effect of the disease on their lives.
   (R) Open discussion helps identify the need for practical skills manage RA.