RA Concept map

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Pharmacologicals

Corticosteroids

NSAIDS

DMARDS

Other joints including proximal interphalangeal joints, shoulder, elbows, hips, knees and ankles

Nursing Intervention: Educate patient to report signs and symptoms of infection

Nursing Intervention: Encourage patient to engage in physical activity to slow down joint damage

Nursing Intervention: Educate patient on using heat and cold therapy to relieve inflammation and pain

RHEUMATOID ARTHRITIS CONCEPT MAP

9. Destruction and calcification of articular cartilage and underlying bone

Chronic Systemic Symptoms from calcification of articular cartilage

Rheumatoid nodules

Localized joint inflammation

Morning Stiffness for more than 30 min

Joint redness

Joint swelling

joint pain

Permanent hand deformity

Boutonniere

Swan's neck

Neutrophils and macrophages phagocytize immune complexes releasing lysosomal enzymes that destroys articular cartilage

Presence of Anti-cyclic citrulline peptide antibodies

70-80% of people who have RA have a RF factor which is an antibody that reacts with a fragment of IgG to form immune complexes

Cigarette smoking is the strongest risk factor for the development of RA

Disease onset: occurs at any age, peak incidence between 50-75 years old. Women are affected more frequently than males

1. Genetic environmental and immunologic factors

2. Activation of T cell mediated immune response (CD4+ cells, interleukin, and tissue necrosis factor)

Mediator: Release of TNF, IL-1

3. RF antigen/ IgG interaction

4. Immune Complexes deposited into joint space and osteoclasts are activated

5. B and T lymphocytes to stimulate the inflammatory response

Chronic Inflammatory Symptoms

Rheumatoid Vascularitis

Acute inflammatory symptoms

Fatigue

Weakness

6. Angiogenesis in synovium

7. Synovial proliferation causing thickening and fluid accumulation

8. Pannus formation of granulation tissue that is composed of inflammatory cells that erodes the articular tissue.