Chronic Illness Rheumatoid Arthritis

Chronic Illness Paper

Objective:
Describe the effects of the illness, levels of prevention, best nursing practices in relation to the illness, developmental issues for the clients as well as caring and interdisciplinary strategies to address the bio-psychosocial and economic needs of those with the chronic illness.

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Include in the paper the following:
1. Introduction to the paper MUST be one paragraph on Rheumatoid arthritis.

2. An overview of the Rheumatoid arthritis including personal (the patient) and population effects (e.g. statistics) of this chronic health problem.

Describe primary, secondary, and tertiary prevention strategies related to this illness including three (3) major ongoing aspects of treatment. Use evidence-based practice (EBP), peer reviewed journal articles (within last 7 years). No websites. Cite original authors.

3. Explore and discuss evidence of three (3) best nursing practices related to this illness (from the aspects of treatment discussed in #2) using research articles referenced in ongoing aspects of treatment.

4. Discuss three (3) psychosocial concepts as related to the chronic illness diagnosis (for example stigma, quality of life, health promotion, sexuality, social isolation, adaptation, adherence) with EBP peer-reviewed references for the concept. Concepts must be defined, and discussion should include what knowledge you learned from the cited references as well as implications for nursing practice. Limit MUTS BE ONE paragraph per concept.

5. Identify aspects of teaching (nursing interventions) that address the individual concerns of the client, family and teaching for the community. Present valid, EBP resources available for individuals and families dealing with the chronic illness. State resources examples found in the community.WHAT ARE YOU GOING TO DO AS A NURSER FOR YOUR PATIENT WITH THIS ILLNESS

6. The paper should have a brief but pertinent conclusion. Limit to one paragraph.
The paper should be concise, edited for format and content, all resources are to be cited in APA 7th edition format and hyperlinked. Do not use “direct” quotes but put all information in your own words.
Paper should be in APA 7th edition format using headings. See rubric for requirements of paper.

pointers:
primary Intervention
•There are no modifiable risk factors that have been identified. There are no real defined primary prevention strategies of RA.
•Lifestyle modifications are common request in individuals at a higher risk of developing Rheumatoid Arthritis
•EXAMPLES:
•Cessation of smoking
•Weight control & diet
•Physical activity
•Infectious disease control/vaccines
•Occupation & sport injury prevention

(Finckh & Deane, 2014)

secondary prevention:
Laboratory studies include:
•Erythrocyte sedimentation rate (ESR)
§confirms the presence of inflammation
•C-reactive protein (CRP) level
•Complete blood count (CBC)
§low hemoglobin, hematocrit, red blood cell
•Rheumatoid factor (RF) assay
§measures the presence of antibodies (IgG and IgM)
•Antinuclear antibody (ANA)
§ measures for antibodies that cause tissue death
§RA: positive titer (greater than 1:40)
•Anti−cyclic citrullinated peptide (anti-CCP)
§specific to detecting early RA
§marker for late-stage disease
(Vivienne & Michael, 2018).

Tertiary prevention
Medical Management:
•The aim of this strategy is to limit the impact of the disease. This is where most rheumatic diseases are dealt with. Administration of DMARDs is carried out at this stage
•Medications employed in the treatment of RA are the Non-steroidal anti-inflammatory drugs (NSAIDs) and the Disease Modifying Anti-rheumatic Drugs (DMARDs) DMARDs should be introduced in all patients.
•An example of the NSAID used is Celecoxib (Brand name: Celebrex).
•An example of DMARD is Sulfasalazine (Brand name: Azulfidine).
•Immunosuppressant drugs such as Glucocorticoids, Ciclosporin and Azathioprine.
•Anti-cytokine drugs and other biopharmaceuticals e.g., Rituximab
(Bullock et al., 2018) (Vivienne & Michael, 2018)

Nursing Interventions
Psychological intervention.
• From the study, Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials, conclusions were made on the need for psychological support in RA patients.
• The study showed that psychological support was important in encouraging the need for physical activity
• Psychological support was also shown to reduce incidences of depression and anxiety among RA patients
(Knittle, Maes and de Gucht, 2010).

Nurse-driven phone calls to ensure continuity of care and support.
• A study on Nurses’ roles in the management of chronic inflammatory arthritis suggested that nurses should contact their RA patients.
• The study showed that a health follow up for RA patients with less severe disease achieved a similar disease control as conventional outpatient follow up (Vivienne and Michael, 2018).
• Nurse-driven phone calls increases patient satisfaction, reduces psychological issues associated with the disease and increases treatment safety.
(Vivienne and Michael, 2018).

Promotion of Exercise and Mobility
The article, Benefits of Exercise in Rheumatoid Arthritis stresses the need for inclusion of physical exercises in the treatment of RA.
• The shows that exercise improves the quality of life of RA patients without any proven adverse effects.
• Research shows that both aerobic and strain training are important
• All RA patients should be encouraged to incorporate both aerobic and resistance training in their routine These self management skills include:
• Enhanced knowledge on the disease.
• Physical activities such as walking and swimming.
(Cooney et al., 2011)

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