Rheumatoid arthritis: Chronic symmetric polyarthritis is the main manifestation of this disease, which is progressive. It is an aggressive disease, mainly synovial lesions, which attack and destroy the bony joints and eventually lead to joint ankylosis. deformity and different degrees of disability.
I. General care
1, the acute phase of joint swelling and pain is obvious, and the systemic symptoms of patients, should be bed leisure, should not sleep on a soft mattress, the pillow should not be too high
2, rheumatoid patients joints and surrounding `vascular. Nerve invasion, vascular contraction is slow and inadequate, so that the rise and fall of skin temperature is delayed.
3, pay attention to the joint warmth, to avoid damp cold aggravate joint symptoms.
4, diet: nutritious, correct anemia.
5.Patients in remission should strengthen their activities and perform functional exercises under guidance.
Second, symptom care
1.For patients who are bedridden, pay attention to maintaining the correct position.
(1) The shoulder joint should not be in the external rotation position, the top pillow and other items can be placed on both sides of the shoulder, and a pillow should be placed between the arms to maintain the external shoulder joint.
The patient should maintain a functional position.
(2) Both palms can hold small scrolls to maintain finger joint extension.
(3) Place cushions on both sides of the hip joint to prevent external rotation of the hip joint.
(4) Pillow at the calf of a lying person to prevent the knee joint from being fixed in a flexed position.
(5) Prevent foot drop.
2.Give massage to the swollen and painful joint and supplement with hot hydrotherapy, wax therapy, etc.
3. For acute cases, splinting may be given for a short period of time (2-3 weeks) to maintain the functional position of the joint.
4.If the condition permits, attention should be paid to the movement of the joint and functional exercises should be given, including finger grasping exercises, such as knitting sweater, checkers and playing ball. Wrist. Elbow. Knee flexion and extension exercises, and with a certain amount of passive body movement, but to have ankylosis of the joint prohibit strenuous exercise.
5, for joint activity is limited. Those who cannot completely take care of themselves do a good job in life care and enhance comfort.
6.Cultivate patients’ awareness of self-care.
7.Chest care: chest expansion exercises, back patting and coughing to prevent colds.
8.Care of skin lesions and ulcers at joints: strengthen the change of medication to prevent infection. Apply emollient cream to protect the skin at regular intervals.
Assess the patient’s pain, and give non-steroidal anti-inflammatory drugs as prescribed by the doctor for obvious joint pain. Observe the efficacy and side effects of drugs.
Third, drug observation.
Pay attention to the side effects of non-steroidal anti-inflammatory drugs and immunosuppressive drugs.
Observe the condition of
1.Joint swelling and pain; activity; self-care; joint symptoms.
2. Anemia.
3.Lung condition: interstitial lung fibrosis.
4, nerve compression symptoms.
5.Peri-articular skin lesions: due to vasculitis.
6. Understanding the measurement criteria for the degree of arthritis impact.
V. Psychological care
VI. Discharge instruction
VII. Common nursing problems
Pain – related to rheumatoid.
Defective self-care ability – related to limited joint movement.
Risk of disuse syndrome – related to joint bone destruction.