Page 2124 - Saunders Comprehensive Review For NCLEX-RN

C. Rheumatoid factor
1. Blood test used to assist in diagnosing rheumatoid
arthritis
2. Reference interval: Negative or less than 60 IU/mL
D. Medications: Combination of pharmacological therapies includes
NSAIDs, disease-modifying antirheumatic drugs (DMARDs), and
glucocorticoids
E. Physical mobility
1. Preserve joint function.
2. Provide range-of-motion exercises to maintain joint
motion and muscle strengthening.
3. Balance rest and activity.
4. Splints may be used during acute inflammation to
prevent deformity.
5. Prevent flexion contractures.
6. Apply heat or cold therapy as prescribed to joints.
7. Apply paraffin baths and massage as prescribed.
8. Encourage consistency with exercise program.
9. Use joint-protecting devices.
10. Avoid weight bearing on inflamed joints.
F. Self-care (Box 60-5)
1. Assess the need for assistive devices such as raised
toilet seats, self-rising chairs, wheelchairs, and
scooters to facilitate mobility.
2. Work with an occupational therapist or PHCP to
obtain assistive or adaptive devices.
3. Instruct the client in alternative strategies for
providing activities of daily living.
G. Fatigue
1. Identify factors that may contribute to fatigue.
2. Monitor for signs of anemia and administer iron, folic
acid, and vitamins as prescribed.
3. Monitor for medication-related blood loss by testing
the stool for occult blood.
4. Instruct the client in measures to conserve energy,
such as pacing activities and obtaining assistance
when possible.
H. Disturbed body image
1. Assess the client’s reaction to the body change.
2. Encourage the client to verbalize feelings.
3. Assist the client with self-care activities and grooming.
4. Encourage the client to get dressed daily and to wear
street clothes.
I. Surgical interventions
1. Synovectomy: Surgical removal of the synovia to help
maintain joint function
2. Arthrodesis: Bony fusion of a joint to regain some
mobility

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