Rheumatoid Arthritis
Insert your name in the header. Type your answers in RED, save your final copy in Word (.doc or .docx). Send as an attachment to your clinical instructor and cc Miss Williams. In order to receive full attendance credit, we MUST receive your assignment by: 0630 9/27/16 and med cards by 0800 9/28/16.
1. What 3 questions the nurse should ask when assessing a client’s ROM with RA?
a. Is there pain on motion?
b. Is there limitation of motion? Can patient to active or passive motion?
c. Assess muscle tone, strength, coordination
d. Does the patient need assistive devices to perform ADL? (recommend occupational therapist)
e. Idk this one.. google it
2. What are 3 important considerations for the nurse when overseeing the care
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Provide answers to the following, you may consult evidence based resources to provide answers to the following (cite your source in APA format):
Explain what the fallowing pathophysiological changes to AUTOIMMUNE REACTION
(Please write in your own words and cite your reference)
CHANGE WHAT DOES IT MEAN
Antigens to T cells T cells are used to find infected cells that are tagged with a specific antigen. Once the antigen is in contact, the T cells will destroy the cell; this results in cell mediated immunity. (ahn pg 740)
Inflammatory process The process of inflammation helps the body get rid of dead tissue and pathogens in order to repair body tissues and cells. When the inflammatory response is triggered (by chemical and physical agents or microorganisms), the site injured is brought nutrients, products of blood, and fluid. The signs of inflammation include loss of function, edema, pain, erythema, pus drainage, and heat. (FON pg 125 or 289)
Increased capillary permeability In inflamed tissues, the capillaries will have increased permeability. This causes edema at the injured site due to the increased blood flow (to carry nutrients and white blood cells to repair the injury).
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This can lead to pain, swelling, inflammation, and damage to the joints affected. http://www.arthritis-health.com/types/rheumatoid/what-pannus T- and B cell proliferation Angiogenesis in synovial lining T and B cells are some of the main immune cells for synovial membrane inflammation. T cells proliferate in the synovial membrane in response to a specific antigen (ex: cartilage autoantigen) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897168/). B cells produce cytokines and chemokines to promote angiogenesis and leukocyte infiltration in the joints (https://www.ncbi.nlm.nih.gov/pubmed/15180890) . Angiogenesis in the synovial lining can be a key factor in treating arthritis
8. Make medication cards for (due on 9/28 at 0800): glucosamine, celecoxib, methotrexate, leflunomide, meloxicam
9. Formulate a Nursing Care plan (3-part statement incl R/T and WEB) for a client with RA
With one short-term/one long-term goal, at least 4 nursing interventions with scientific
What is the physiologic mechanism causing the wound to become red, hot, swollen, and painful?How is this different than the inflammatory response that might occur in an internal organ?
The B cells, T cells, Macrophage, and Antibodies are all a very large part of the immune system. There are two types of T cells, killer and helper T cells. Killer T cells find and destroy cells infected with bacteria, and helper T cells control the activity of other cells in the immune system. Then, B cells are considered the “clean up crew,” attacking any bacteria or viruses the T cell left behind. They also make antibodies, which are essential for trapping invading viruses and
inflammatory infiltrates, add fuel to the fire so to say. Lymphocytes infiltrate the spinal and
With two weeks of clinical experience, my plan for this clinical day draws directly off my pervious experiences. I will start my clinical day by getting with my FOR and administering medication to my assigned resident. This activity will probably take around an hour, as my assigned resident takes numerous medications, and I must perform the skill safely - six rights and three checks. After my medication administration skill, I will take vital signs, perfrom CNA skills, feed the residents, and monitor glucose with any additional time I have in the morning. Around 11 o 'clock, our group normally gathers together and takes a lunch break for half hour. After the group lunch break, I would like to get with my partner and begin to fill out our concept worksheet - Infection - for this week. My partner and I will walk around the long term care faiclity and observe what infection control precautions are taken to prevent infections when caring for residents, and consider what further interventions we could implement into our care. When we complete our concept map, I would like to gather this week 's required information from our assigned partner and her medical record - Fall risk/mobility, systems assessment, basic nursing care choices, and vital signs. While gathering information from our assigned resident, we will assist with her care, if needed. With the information we gather from our assigned resident, and her medical record, we can further complete our concept map, drawing additional links, if observed. With my medication administration complete, and my required information gathered, I will spend the rest of the clinical day answering any call
The job of the immune system is to keep “foreign” invaders out of the body, or if one gets in, to seek it out and kill it. These foreign invaders are called pathogens, which are tiny organisms that can cause an infection in the body. Pathogens can be bacteria, parasites, and fungi (http://www.niaid.nih.gov/topics/immuneSystem/pages/whatisimmunesystem.aspx).
To be able to determine which task the immune system needs to take to fight off the pathogen, it must be able to differentiate between self and non-self-substances. The immune system gets activated by the non-self-substances called antigens. The antigens attach to special receptor sites on defense cells which starts cell processes. If the body has come in contact with the antigen before, it will be able to respond to it more quickly (PubMed Health).
Develop plan of care that meets the needs of the patient in this particular situation.
Arthritis affects people of all age groups. More than 100 types of arthritis are known. Among these osteoarthritis and rheumatoid arthritis having the highest incidence. One of the major causes of chronic debilitation in industrialized nations is Osteoarthritis which results from damage to the joints, which may be due to trauma, infection, or age-related wear. Rheumatoid arthritis is encountered less frequently than osteoarthritis and is estimated to affect around one per cent of the world’s population. Amongst patients of Rheumatoid arthritis, women are three times more likely to be affected by this condition than men. This condition is caused by an inflammatory process where the body starts attacking itself. Rheumatoid arthritis also affects several joints, with inflammation sometimes seen in and around the lungs, the heart, the eyes and the skin. The most commonly reported complaint by arthritis patients is pain. The pain might be from the joint itself and be a result of inflammation, damage from the disease, or through daily wear and tear. Muscle pain is also common and is caused by having to force movements against stiff and painful joints. Although range of movement in the affected joint may be limited and uncomfortable, physical exercise has been shown to benefit those with arthritis. Physical therapy has been shown to significantly improve function, decrease pain in the long term and delay the need for surgery in advanced cases. The majority of arthritis cases occur among theelderly, however the disease can occur in children as well. Over 70% of the population that get affected by arthritis in North America are over the age of 65 (4). The disease occurs more commonly in females than males in all races, age groups, and ethn...
... basic information of the patient. Professional and precise language should be used when documenting. For the care plan, I have learned to correctly write a nursing diagnosis and writing interventions that are within nurses’ capability and suits the patient’s personal status. From now on, I will remember to distinguish medical diagnosis from nursing diagnosis. For each diagnosis, I will write about the patient’s (potential) response to the health problem and state why this might be the concern.
The symptoms experienced by Carlton are in the group of the cardinal signs of inflammation that have been identified for centuries (Grossman & Porth, 2014). Carlton’s wound is in the first stage, the inflammatory phase, of acute inflammation, which is the beginning of a complex, regulated, and critical process of immunologic events (Rosique, Rosique, & Farina Junior, 2015). There are two main types of stimuli that cause this kind of biological and immunological reaction: physical injury and microbial infection (Qian et al., 2016).
The third line of defence in the body's immune response is the specific response. If there are still any pathogens in the body after the first responses have occurred they are targeted according to their type by the third defence. This third defence is a specific immune response, and it produces and binds protein molecules know as an antibodies to specifically target an antigen - which is typically a pathogen itself or a marker molecule on the surface of the pathogen. When the body becomes infected with a pathogen, certain antibodies are created by the third defence to attack that pathogen. Once these antibodies have been produced to fight off specific antigens they are remembered by the body and if the same antigen tries to invade again, it is instantly targeted and destroyed, as the body is now
The macrophages engulf and digest the foreign pathogens and leave behind parts of the pathogen called antigens that stimulates the immune system to attack them. The T-lymphocytes are a type of white blood cell that can recognize antigens that are not part of the human body (non-self) and attack the human cells that have been invaded by the pathogen associated with this non-self antigen. B-lymphocytes, another type of white blood cell, also recognize foreign antigens and produce antibodies that attack and neutralize the foreign antigens to fight the infection. When a new pathogen is first detected by the immune system, it can take up to several days for the immune system to properly coordinate all the different immune cells required to fight the infection (Understanding How Vaccines Work, 2013). However, once the infection has been eliminated, the immune system has the ability to remember all of the foreign antigens that have entered the body. The memory T-lymphocytes and memory B-lymphocytes will remember every antigen they have ever encountered throughout the human’s lifetime and are able to quickly respond and initiate the immune response if the same antigen is detected again. The immune system keeps a huge supply of “millions and possibly billions of different antibodies on hand to be prepared for any foreign invader by constantly creating millions of new B cells” (How Do Vaccines Work?, 2011). This process of antigen memory and antibody production is also called acquired immunity, and it the basis to understand how vaccines
(A)Wound healing is a biological process occurring in the human body. In this lecture we had discussed about both acute and chronic wounds. An acute wound is an injury to the skin that occurs suddenly rather than over time. It heals at a predictable and expected rate according to the normal wound healing process. The chronic wounds do not heal in an orderly set of stages and in a predictable amount of time the way most wounds do.