2. Objectives
• Identify connective tissue diseases
• Describe the nursing care for rheumatic diseases and
rheumatoid arthritis
• Identify the risks for rheumatoid arthritis
• Lists signs and symptoms for rheumatoid arthritis
• Describe the medical management for rheumatoid arthritis
• Describe the pathophysiology and symptoms of SLE
• Describe the medical management for SLE
3. Diffuse Connective Tissue Diseases
• A group of chronic disorders characterized by diffuse
inflammation and degeneration in the connective tissue
• Cause is unknown but thought to have an immunologic
basis
• Characterized by a clinical course of exacerbations and
remissions
• Includes RA, SLE, scleroderma, polymyositis, and
polymyalgia rheumatica
4. Systemic Effects: Extraarticular Features
• Exacerbations & remission
• Fever
• Fatigue
• Anemia
• Lymph node enlargement
• Any organ system may be
involved; arteritis, neuropathy and
other neurologic manifestations,
scleritis, pericarditis, pleural
effusion, splenomegaly, renal
involvement
• Skin and mucosal manifestations
5. Rheumatic Diseases
• “Arthritis”
• More than 100 different disorders
• Affect primary the joints, but also muscles, bone,
ligament, tendons, cartilage
• Classification
• Monoarticular or polyarticular
• Inflammatory or noninflammatory
6. • Characterized by inflammation of joints, systemic
manifestations
• Treatment
• Mild analgesics to
• Provide pain relief
• Reduce inflammation
• Corticosteroids to treat inflammation
• Radiation to suppress body’s abnormal
antigen–antibody responses
Rheumatoid Arthritis
9. Patient Assessment and Diagnostic
Findings
• Health history: include onset
of and evolution of symptoms,
family history, past health
history, and contributing
factors
• Raynauds’s Phenonmenon
• Functional assessment
• Arthrocentesis
• X-rays, bone scans, CTs, and
MRIs
• Tissue biopsy
• Blood studies
10. Nursing Interventions
• Understanding of the underlying disease process guide;
the nurse’s critical thinking to provide interventions
• The extent of the disease process, and whether it is
localized or more systemic, will also affect nursing
activities
11. Nursing Process: The Care of the Patient
with a Rheumatic Disease—Diagnoses
• Acute and chronic pain
• Fatigue
• Disturbed sleep pattern
• Impaired physical mobility
• Self-care deficits
• Disturbed body image
• Ineffective coping
13. Nursing Process: The Care of the Patient
with a Rheumatic Disease—Planning
• Major goals may include:
• Relief of pain and discomfort
• Relief of fatigue
• Promotion of restorative sleep
• Increased mobility
• Maintenance of self-care
• Improved body image
• Effective coping
• Absence of complications
14. • Chronic systemic disorder
• Caused by development of antibodies that
fight body’s own tissues, cells
• Effects
• Damage to connective tissues, the hematologic
system, skin, kidneys, heart, brain
• Treatment
• Education in rest, stress management
• Use of anti-inflammatory agents and
corticosteroids
Systemic Lupus Erythematosus
15.
16.
17. Teaching Patients Self-Care
• Explain the disease and principles of disease management
• Medication teaching
• Monitoring
• Sources of information
• Pain management
• Joint protection
• Self-care with assistive devices
• Exercise and relaxation