Ra Medical Case

When comparing this patient to a healthy patient it is obvious that she has some mobility issues and some pain. Mrs. Johnson’s RA has taken a toll on the body and joints. Her ankles showed signs of swelling. She cannot sit for too long, otherwise her legs will start to fall asleep and she will have a lot of trouble standing up. Mrs. Johnson has a great attitude and manages to get around fine. She moves slow and stiff but gets where she needs to go.

At today's visit he is accompanied by his son in law and daughter. He reports pain in his hands and fingers that is a result of his RA. The pain starts in his fingers and radiates up his arms. He also complain of pain in his back that he contributes to his history of herniated discs. The severity of his pain is a 2/10. He decribe the pain as a shooting pain that is worst at night and when he relaxes. He states that since starting oxycodone IR 5 mg every 8 hours as needed, his pain is much better. He takes an average 1-2 prn dose daily. He feel that this regimen is effective in palliating his pain. He complain of neuropathic pain in legs, he have numbness and tingling in both lower legs. He uses Voltarin Cream BID and take Gabapentin 400mg

use are drugs. The drugs that are used, tend to ease the symptoms and slow R.A. activity. Non-steroidal anti-inflammatory drugs include ibuprofen, ketoprofen, and naproxen sodium. These are the drugs that tend to ease the pain. Corticosteroids, disease- modifying anti rheumatic drugs (DMARDs), Biologics, and Jak inhibitors are drugs that tend slow R.A.s activity. Steroids and biologic agents such as Prednisone and adalimumab (Humira) are also recommended and used for people with R.A. All these different drugs are used to try and stop the progression of R.A. Most pharmaceuticals only reduce inflammation and pain. Although there isn't one particular drug at this point that can stop Rheumatoid Arthritis, drugs such as Ibuprofen do help and are considered the top drug that is used to treat inflammation and pain for R.A.

It is most important for the patient to educate themselves about the disease and their treatment options, as well as maintain a healthy lifestyle, weight, and continue to take part in physical activities. Several things can be done to conserve joint function, mobility, and the patient's overall quality of life. Doctors will often use aggressive treatment early in the progression of the disease in attempt to decrease the severity of the symptoms. Possible treatments include medications, surgery, and lifestyle

Rheumatoid arthritis is characterized by excessive inflammation, particularly in the joints leading to irreversible damage (Contreras-Yáñez, Ponce De León, Cabiedes, Rull-Gabayet, and Pascual-Ramos, 2010). Pain and joint damage leads to limited mobility, decreased function and a reduced quality of life (Elliot, 2008). TNF blockers provide significant improvement in patient outcomes “by reducing pain,

Biologics first made their premier as a treatment option for Rheumatoid Arthritis (RA) over fifteen years ago, when Enbrel was first introduced. Now it is one of the front runners for treatment of RA. Many studies and articles, such as Palmer’s (2012) article out of the British Journal of Nursing, has shown how beneficial and impactful Enbrel has been as a treatment option. Enbrel.com proclaims how symptoms start to improve in as early as two weeks, with most people seeing improvements within three months, with even more improvements seen by six months. The article by Dhillon, Lyseng-Williamson, and Scott (2011) states that in several well designed trials in patients with early or long-standing

If ones doctor suspects RA they may perform blood test to check for protein in the blood (This is present in about 2 in 3 people with RA. However, about 1 in 20 of the normal population has rheumatoid factor), and x-rays of the hands and feet may be done to detect any early deformations of the joints. If an individual’s doctor suspects that they may have RA, they usually will refer the patient to a rheumatologist who specialize in the joints and this type of disease. There is no cure for RA, but proper treatment for RA can make a big difference in reducing symptoms and to improve quality of life. Some of the main aims of treatment are: to decrease the disease from progressing to prevent joint damage, to reduce pain and stiffness in the affected joints, to minimize any disability caused by pain, joint damage, or deformities. A common medication prescribed for RA are disease modifying anti-rheumatic drugs (DMARDS) such as methotrexate, sulfasalazine, and hydroxychloroquine. This can be with medication such as steroids, NSAIDS, and often times will treat with pain killers because the pain is so intense. Eating a healthy diet and excising is always

It is very important to know how to cope with and manage symptoms of RA. For example, my family member who went through the experiences of RA, and developed depression when she found out she has to take multiple medications, which had dangerous symptoms. She has gotten better over time, but that is only with the help and support of family and close friends. One way to manage the symptoms of RA was continuing to do things she enjoyed. In other words, the symptoms of RA cause stress and it is important that patients stay mentally positive. By doing activities a person loves, people will “feel good,” and be optimistic about life, and managing the symptoms of RA. Therefore, it is important to have the support of family and friends when dealing Rheumatoid Arthritis

The type of treatment chosen depends on the type of arthritis and the effects it has on the patient as well as the severity of the disease. Other factors to consider are the age of the patient and the joints affected. Bearing in mind that different people exhibit different reactions to different medications, treatment in this case is individualized but includes a combination of joint protection methods and medication. For rheumatoid arthritis, the Initial treatment starts with non steroidal ant inflammatory drugs and other simple analgesic but as the inflammation progresses, slow acting anti rheumatoid drugs which are aimed at modifying the disease are introduced. They are added progressively as the inflammation progresses in order to suppress the process that leads to chronic inflammation (Amin 1995).

If the child’s case does not respond to NSAIDs, the doctors move to DMARDs (Disease-modifying antirheumatic drugs). The drugs commonly used in this category are methotrexate, and sulfasalazine which are used to prevent the progression of JRA. These can, and often are used in combination with the NSAIDs. (1)

RA is a mediated inflammatory process that triggers an autoimmune response. The result is in the production of antibodies and inflammatory cytokines that over time destroys bone, cartilage, tendons, ligaments and blood vessels (Dewing, Setter, & Slusher, 2012). Although joints are the primary areas of destruction, the inflammatory process can also affect various organs, such as heart tissue including the heart values, visceral layers of the lung and brain, spleen, sclera and larynx (Dunphy, Windland-Brown, Porter, & Thomas 2011). If RA is not treated promptly or if the patient does not respond to treatment, irrevocable bone deformity, bone erosion and immobility is often the sequelae.

The NRS for pain is a unidimensional measure of pain intensity in adults including those with rheumatic arthritis. Just like VAS and VRS, it is a pain assessment method to assess pain intensity in persons who are able to self-report. In this case, self-report of pain is defined as the ability to indicate presence or severity of pain verbally, in writing, or by other means such as finger span, pointing, head movement, or blinking eyes to answer yes or no questions (Hadjistavropolous et al, 2007) .The NRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent will require to select a whole number (0–10 integers) that best reflects the intensity of their pain (Hawker et al, 2011). Similar to the pain VAS and VRS,

Throughout this essay I shall critique the available evidence regarding rheumatoid arthritis (RA); particularly concerning the conclusions on its aetiology, diagnosis techniques, pharmacological management, physical therapeutics and surgical treatment interventions. I shall explore the expected prognosis and the key developments we can expect in the future.

As pointed out previously the presentation and clinical expression of RA is highly variable between patients. Moreover, the signs and symptoms of RA cover a wide-ranging spectrum, varying from pain, stiffness, swelling and functional impairment (Taylor 2007; Heidari 2011; Crawford 2015). Therefore, clinical diagnosis of RA is greatly individualised process (Heidari 2011), which makes it fundamentally hard to establish a uniform diagnostic criteria (Aggarwal et al. 2015). Considering the absence of specific test for diagnosis of RA, the majority of treatment trials published in the last two decades included patients who fulfil the 1987 American College of Rheumatology (ACR) as a diagnostic criteria of RA (van der

Current medications: Prescribed Antacids, Nexium, q24h, or when pain is severe, Tylenol 500 mg, PO, q12h.