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