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