Post on 07-Nov-2014
Presented byIra Suarilah
Medical Surgical Nursing DeptAirlangga Universitas
PREVIEW
• A Number of disease that cause: Chronis pain Stiffness or swelling around joints & Tendon
• Distinguished by: Their chronicity The appereance of local & systemic features of inflammation
• Commonest cause of inflammatory joint disease most typical features: Symmetrical polyarthitis & tenosynovitis Morning stiffnes Elevation of ESR Appereance of anti IgG (Rheumatoid factor)
• 3X >> woman Because of hormon: Estrogen
AMERICAN RHEUMATOID ASSOCIATIONRheumatoid Arthritis Criteria
• Kaku pagi hari lebih dari 1 jam• Terdapat arthritis pada 3 daerah
Minimal terdapat efusi pada 3 sendi secara bersamaan pada:–Proximal interphalangeal–Metacarpophalangeal–Metatarsophalangeal bilateral
• Arthritis pada persendian tangan• Arthtritis simetris:
- Proximal interphalangeal- Metacarpophalangeal- Metatarsophalangeal bilateral
• Nodul rheumatoid• Rheumatoid factor at a level above the 95th percentile• Penurunan kadar kalium• Rheumatoid factor• Perubahan gambaran anatomis• X-ray Erosi,dekalsifikasi tulang
POSITIF Rheumatoid Arthritis Terdapat 4 dari 7 kriteria di atas
1.Synovitis & joint swelling(painfull,swollen,tender)
2. Early joint destructionwith periarticular erosions(bone was eroded)
3. Advanced jointdestruction & deformity(capsular & tendon ruptur)
NURSING DIAGNOSIS
Physical mobility,impaired, related to– Pain– Oedema– Limited range of motion of affected bone
Pain related to• Experience during invasive procedures/• diagnostic testInjury risk related to• Immobility• Instability of skeleton
ASSESSMENTTHERE’S NO CURE but CARE
1. Stop synovitis– Bed rest– Gentle passive & active exercise Prevent Postural deformities
2. Prevent deformity- Physioterapy- Postural training
3. History of muscle pain, tiredness, lost of weight & general lack of well being4. Rehabilitate
- Functional assessment- Social integration Home Care- Psychological support
• Rehabiliatsi:• Merupakan tindakan untuk mengembalikan tingkat kemampuan klien
dengan R.A
ASSESSMENTTHERE’S NO CURE but CARE
• Mengurangi rasa nyeri• Mencegah terjadinya kekakuan &
keterbatasan gerak sendi• Mencegah terjadinya atrofi & kelemahan
otot• Mencegah terjadinya deformitas• Meningkatakan rs.nyaman & kepercayaan
diri• Mempertahankan kemandirian