Presented by Ira Suarilah Medical Surgical Nursing Dept Airlangga 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 ASSOCIATION Rheumatoid 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 destruction with periarticular erosions (bone was eroded) 3. Advanced joint destruction & 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 test Injury risk related to Immobility Instability of skeleton

ASSESSMENT THERES 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 being 4. Rehabilitate - Functional assessment - Social integration Home Care - Psychological support
Rehabiliatsi: Merupakan tindakan untuk mengembalikan tingkat kemampuan klien dengan R.A

ASSESSMENT THERES 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