The Standards of Care of a Patient with Rheumatoid Arthritis Essay
The Standards of Care of a Patient with Rheumatoid Arthritis Essay
Other symptoms include fatigue, articular stiffness, anorexia and fever. A complaint of pain and limited lifestyle are the characteristic features of the onset of the disease. If left untreated, the inflammation will result in serious life-threatening conditions during its progression. Morbidity, progressive disability and hastened mortality feature the untreated disease conditions. As a result, it entails serious economic implications for both the patients and their families as well as society as the affected people are unable to continue in their employment with the same efficiency as before with the normal functioning of their palms, feet and gait seriously affected and progressively disfigured and disabled (Cush, Weinblatt, Kavanaugh, 2010). According to the National Audit Office, there are around 580,000 people afflicted with RA with additional 26,000 new cases every year. The disease affects people of age between 40 to 60 years with women who are three times more likely to be affected than men. The Standards of Care of a Patient with Rheumatoid Arthritis Essay. The patient referred herein for treatment also happens to be a woman aged 40. This being an auto-immune disease, affects small joints of the hand and feet. If severe, it reduces life expectancy by 6-10 years as a result of co-morbidity through cardio-vascular diseases or side effects from treatment (Home Carr, n.d.) The disease reduces the affected person’s work-life by five years. Its annual cost to the U.K. economy is estimated to be between £ 3.8 and £ 4.75 billion (NationalAuditOffice, 2009). There are many institutions engaged in the care of RA with their own guidelines for treatment. British Society for Rheumatology (BSR, (n.d)), NHS (NHS, n.d.), National Rheumatoid Arthritis Society (NRAS) (NRAS, n.d.), The Society of Chiropodists and Podiatrists (SCPOD, n.d.), The Musculoskeletal Services Framework (DeptOfHealth, 2006), NSF long-term conditions (DeptOfHealth, Department of Health, 2005), 18-week commissioning pathway (DeptOfHealth, Department of Health, 2006) and Podiatry rheumatic care associations (PodiatryRheumaticCareAssociation, n.d.) are the major sources of standards of care for RA conditions.
ORDER A PLAGIARISM-FREE PAPER NOW
Proliferation of the synovial membrane and uncontrolled persistent inflammation are the characteristic features of RA which manifest as a symmetric arthritis affecting several small and large joints. Other symptoms include fatigue, articular stiffness, anorexia and fever. Complaint of pain and limited lifestyle are the characteristic features of the onset of the disease.The Standards of Care of a Patient with Rheumatoid Arthritis Essay. If left untreated, the inflammation will result in serious life threatening conditions during its progression. Morbidity, progressive disability and hastened mortality feature the untreated disease conditions. As a result, it entails serious economic implications for both the patients and their families as well as society as the affected people are unable to continue in their employment with the same efficiency as before with their normal functioning of their palms, feet and gait seriously affected and progressively disfigured and disabled (Cush, Weinblatt, & Kavanaugh, 2010). According to National Audit Office, there are around 580,000 people afflicted with RA with additional 26,000 new cases every year. The disease affects people of age between 40 to 60 years with women who are three times more likely to be affected than men. The patient referred herein for treatment also happens to be a woman aged 40. This being an auto-immune disease, affects small joints of the hand and feet. If severe, it reduces life expectancy by 6-10 years as a result of co-morbidity through cardio-vascular diseases or side effects from treatment (Home & Carr, n.d.) The disease reduces the affected person’s work life by five years. Its annual cost to the U.K. economy is estimated to be between ? 3.8 and ? 4.75 billion (NationalAuditOffice, 2009). There are many institutions engaged in the care of RA with their own guidelines for treatment. British Society for Rheumatology (BSR, (n.d)),NHS (NHS, n.d.), National Rheumatoid Arthritis Society (NRAS) (NRAS, n.d.), The Society of Chiropodists and Podiatrists (SCPOD, n.d.), The Musculoskeletal Services Framework (DeptOfHealth, 2006), NSF long-term conditions (DeptOfHealth, Department of Health, 2005), 18 week commissioning pathway (DeptOfHealth, Department of Health, 2006) and Podiatry rheumatic care associations (PodiatryRheumaticCareAssociation, n.d.) are the major sources of standards of care for RA conditions. They are complementary to one another and it is worthwhile referring to all of them while dealing with the patient affected by RA. Brief outline of care Two of the inevitable symptoms RA are joint pain and stiffness that manifest in the foot and ankle in the early stages.The Standards of Care of a Patient with Rheumatoid Arthritis Essay. These symptoms also change during the course of progression of the disease (Helliwell, 2006). Since rheumatoid arthritis is not curable, the aim of care is to relieve symptoms and improve quality of life for the patient. Although multidisciplinary approach is resorted to, therapeutic interventions are the responsibility of rheumatoid specialist professionals. The patient involvement and empowerment are desirable for a successful outcome with the patient coping up with the course of treatment and lifestyle adaptations (Alexander, Fawcett, & Runcinman, 2006). For control of pain, analgesics such as paracetamol/aspirin, compound analgesics such as cocodamol to NSAIDs can be administered. Since NSAIDs are associated with gastrointestinal side-effects, cyclo-oxygenase (Cox) II group of NSAIDs are recommended so that side effects are at minimal levels. (Alexander, Fawce
Fatigue is another problem if RA is not managed with a balance between rest and activity. Social Isolation could occur from the chronic and acute attacks of RA because of the pain on movement and fatigue, limiting their participation in activities. Depression and Anxiety should be evaluated because of the loss or decline in independence resulting from this chronic disease. The results of a questionnaire revealed the following results; “On the psychological items, 75% (93) of the patients reported difficulty with sleep, 63% (78) with stress, 61% (76) with anxiety and 66% (82) with depression. (Palmer, El Gaafary, & El Mideany, 2007, pg 1011) The patient may be at risk for self-care deficit if any of the following are present: pain, limited movement at joints, fatigue, depression, anxiety, lack of social support, and inadequate knowledge of disease to alleviate and manage symptoms. Implementation “A key factor in managing RA successfully is the engaging of patients in proper self-care
Rheumatoid Arthritis (RA) is a chronic, deforming, and debilitating disease that does not discriminate and attacks women, men, and children at any age. “An estimated 1.3 million people in the United States have RA – that’s almost 1 percent of the nation’s adult population” (Arthritis Foundation, 2011, para. 1). The Standards of Care of a Patient with Rheumatoid Arthritis Essay.
RA is an autoimmune disease of unknown etiology and is characterized for attacking the joints in the entire body. RA is such a chronic deforming disease that eventually, without the proper treatment, can disable anyone. RA is most commonly diagnosed/present in middle age women with family history of RA, but sometimes there is no apparent reason. Currently, there is not enough research that can tell us the causes, way to prevent, or support any lifestyle changes that can improve a patient’s way of life. Therefore, more and more people are facing the reality of this diagnosis with the uncertainty of what is going to happen with their health and their bodies in the future.
RA is an autoimmune disease that is growing worldwide and it does not respect gender, ethnicity, age, or social status. Day after day people around the world are being diagnosed with this debilitating disease facing a diagnosis in which there is not enough research. RA attacks the lining of the joints symmetrically by producing acute/chronic inflammation in both sides of the body. Some of the joints that are most commonly affected are the hands, wrists, fingers, elbows, shoulders, neck, back, hips, knees, ankles, and toes. Pain/tenderness to the joints, stiffness that is more prominent in the morning, inflammation, decreased movement, extreme fatigue, and warm joints are some of the most commons symptoms present with this disease.
Currently, there are a variety of medical treatments that are used to treat RA. Some of the anti-inflammatory medications used are naproxen and ibuprofen that unfortunately, over time, can cause stomach discomfort, some bleeding, and even ulcers.The Standards of Care of a Patient with Rheumatoid Arthritis Essay. There are also other types of medications called Disease Modifying Anti Rheumatoid Drugs (DMARDS) such as methotrexate and the newest types of treatments are the biological medications such as Enbrel and Humira (Finckh, Bansback, Marra, Anis, Michaud, & Liang, 2009). DMARDS and biological medications have dramatically improved the quality of life in patients suffering from RA but still their symptoms do not completely disappear (Finckh et al., 2009). The patients are still in pain, fatigued, and have problems performing their regular activities.
Since RA symptoms can be so strong and debilitating, patients are forced to change their lifestyle. They start losing the mobility and strength in their affected joints and are forced to seek help for the simplest activities that once were so easy to perform such as getting up, walking, toileting, and eating. The symptoms become so difficult and painful that the patient requires assistance for the most basic needs. Patients start losing their independence and become dependent on someone else. For example, a very active individual who once worked and was very socially active becomes a dependent person by needing assistance to get up from bed each morning. Many patients have to quit their jobs, school, social life, or even doing the activities they enjoy because they cannot accomplish them by themselves anymore. Some of these patients become so depressed that they reach to a suicidal stage by just thinking that this way of living will be the rest of their lives.
On a daily basis in the emergency room (ER), we see all sorts of patients but the patients with RA are especially heartbreaking. When a patient arrives in the ER suffering from a flare or because their medication to control their symptoms does not work usually means that the patient is in extreme pain. Getting them from the ambulance stretcher into the hospital bed involves a great deal of pain and effort on their part. Most of these patients are middle aged women that have become disabled due to the extreme joint pain and inflammation. Regularly in the ER, they are only prescribed pain and anti-inflammatory medications in forms of shots and are discharged.The Standards of Care of a Patient with Rheumatoid Arthritis Essay. Doctors and nurses do not explain to the patients any methods to help control their RA symptoms such as changing their diet (vegetarian diet). Vegetarian diet alone will not relieve their symptoms but along with their medications will improve their signs and symptoms significantly or even get them into remission. Doctors and nurses are not familiar with this kind of information and that is one of the reasons that more research is needed so they can become knowledgeable about this disease and distribute the information to their patients. For example, it is commonly known that for some reason red meat can worsen RA symptoms for some patients causing them to experience more pain, inflammation, stiffness, fatigue, and in general to feel worse. There is so little research regarding the effect of vegetarian diet on the signs and symptoms of RA patients but there have been studies that state that diet modification can improve RA symptoms in these patients. Therefore, I have developed the following PICOT questions regarding vegetarian diet as a mean to help improve symptoms in patients suffering from RA:
ORDER A PLAGIARISM-FREE PAPER NOW
For middle age adults, how does the modification of their diet plus taking medication for RA compare to taking medication for RA alone influence the decrease of symptoms related to RA for the rest of their life after being diagnosed with rheumatoid arthritis?
According to Orem’s self care framework the client/patient is responsible and accountable for their own health and the health of their family/dependents (Simmons, 2009). As patient advocates, nurses need to educate and inform their patients in order to give them the tools to improve their health conditions or to improve the health status of their loved ones. The Standards of Care of a Patient with Rheumatoid Arthritis Essay. Nurses who educate their patients regarding diet modifications such as vegetarian diets along their RA medications can drastically improve their quality of life. If the patient’s are educated regarding their condition, their medications, and their diet, they will be capable of taking decisions and modify their treatment to improve their symptoms and regain control of their life. In addition, family members need to be constantly educated regarding the disease, treatments, and diet modifications as tools to be able to improve the health status of their loved ones.
This research topic is very important for me, not only professionally but a personal level as well. Having a close family member with this condition has showed us the little research and information there is out there regarding the disease, treatments, and diet modifications. We have experienced the frustration of not getting information from doctors or nurses and discovered the latest information by performing our own research.
RA is a disease that is under researched for the quantity of existing patients. It is a harsh and life changing disease that causes social, emotional, and physical lifestyle changes to the patients affected. Spreading the word on information regarding this disease can help patients and their families be more empathetic and encouraged to seek answers or at least share common knowledge of comfort techniques or treatments available. Medical staff should step up to the challenge and self educate and share the knowledge to their current and new patients because the simplest information, like diet modification, can make a world of difference. The Standards of Care of a Patient with Rheumatoid Arthritis Essay.
