By Ann Schmidt Luggen Phd RN MSN CS BC-ARNP CNAA, Sue E. Meiner EdD APRN BC GNP
This concise consultant offers nurses with the instruments to assist older adults with arthritis in achieving the top attainable caliber of lifestyles. functional pointers on nursing administration, self care, and the significance of workout are a spotlight all through. half one offers particular arthritic stipulations in a uniform layout -- epidemiology, medical gains and administration, prognosis, pharmacotherapy, and nursing administration and interventions. half provides common ideas for dealing with arthritis, together with complete chapters on a discomfort administration, workout, and sufferer instructing. Any nurse operating with the aged will locate this a basic source.
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Extra resources for Care of Arthritis in the Older Adult (Springer Series on Geriatric Nursing)
Robinson, K. Rogers, & P. ), Primary care across the lifespan (pp. 89-95). St. Louis: Mosby. Cardone, D. , & Tallia, A. F. (1999). Osteoarthritis. In J. K. Singleton, S. A. Sandowski, C. Green-Hernandez, T. V. Horvath, R. V. Di Gregorio, S. R. ), Primary care (pp. 543-548). Philadelphia: Lippincott. , Macera, C. , Davis, D. , Ainsworth, B. , Troped, P. , & Blair, S. N. (2000). Physical activity and self-reported, physician diagnosed osteoarthritis: Is physical activity a risk factor? Journal of Clinical Epidemiology, 3, 315-322.
There is very little information in the literature specifically looking at RA in older adults. However, there are contradictory research reports that suggest that there is a clinical subset of RA in older adults. Clearly, there is a need for research in care of older adults with rheumatoid arthritis, including descriptive research of the most basic nature if we are to make significant improvement in our care of this population.
Any four of the following criteria must be present to make a diagnosis of rheumatoid arthritis (adapted from 1987 American Rheumatism Association revised criteria for the classification of RA): Rheumatoid Arthritis 41 Morning stiffness for > one hour Arthritis in three or more joints; arthritis of hand joints (wrists, metacarpophalangeal or proximal interphalangeal joints ) Symmetrical arthritis Rheumatoid nodules Positive serum rheumatoid factor Radiographic changes in hands typical of RA, including erosions or bony decalcification A history of present illness (HPI) should include (Gordon & Hastings, 1997) Chronological account of illness from the onset Acute or gradual onset Clinical course: duration, frequency, persistence, periodicity Location of pain, radiation of pain Type of pain: quality, intensity, and character Interference by pain with ADLs, lADLs, social life Presence or absence of swelling Associated symptoms: fatigue, systemic complaints Modifying factors: what aggravates it, what relieves it Medications used: effect and side effects Duration of AM stiffness, how relieved Review of joints, periarticular areas, functional indices Psychological effects An assessment should also consider educational, social, and medical histories, including Educational background: affects management and outcome Financial situation: may affect management and follow through Smoking history Hormonal therapies History of medical problems and surgeries Concomitant medical problems Because RA is a systemic illness, a thorough physical examination is essential, documenting presence and absence of features.