Rheumatoid Arthritis 
Definition: this is an autoimmune disease that causes symmetrical inflammation of the joints.
Pathophysiology
This causes oedema, proliferation of the synovial membrane and pannus formation
Pannus destroys cartilage and erodes the bones
These enzymes break down collagen
As a result there is loss of articular surface and joint motion
Phagocytosis produces enzymes within the joints
Muscle fibers undergo degenerative changes
The autoimmune reaction occurs in the synovial tissue
Tendon and ligament elasticity and contractile power are lost.
Stages of Rheumatoid Arthritis
Clinical Manifestations
Nursing Care plan
Stage 2: synovium inflammation causes damage to the joint cartilage. Person experiences pain and loss of mobility.
Stage 3: this is the severe stage, damage extends from the cartilage to the bones. Person experiences muscle weakness. Bone erosion and deformity occurs.
Stage 1: there is inflammation inside the joints, but there is no damage to the bones, synovium is inflamed.
Stage 4: end-stage, joints no longer work and bones become fused together.
On palpation joint tissue is spongy
Disease progression involves joints of the knees, shoulders, hips, cervical spine, etc.
Lack of joint mobility
Early involvement is on joints of the hands, wrists and feet
Joint pain, swelling and warmth
Joint pain when waking up in the morning
If patient has assistive devices, educate on how they are used and how they help recover
Educate patient about the disease and how to incorporate it in their lifestyle
Goals are to relieve pain, minimise joint destruction and promote joint function.
Alleviate anxiety and attend to any patient's concerns with the new diagnosis.