Download Juvenile Rheumatoid Arthritis

A Brief Look at Juvenile Rheumatoid Arthritis
Will Oliver, BSN, RN
Lubbock Christian University
NUR 5200
Introduction to Graduate Studies
Advanced Practice Presentation
Submitted to
Daniel Hatch, DNP, APRN, FNP-BC
Bev Byers, EdD, RN, LMT, LMTI
July 24, 2014
Juvenile Rheumatoid Arthritis
• Adolescents and children, age 16 and
younger(“Childhood arthritis,” 2013)
• Joint inflammation and stiffness lasting 6
weeks or longer (“Childhood arthritis,” 2013)
• Pediatric nursing implications
Pathophysiology
• Malfunction of the
immune system
– Following infectious
disease or other
unknown triggers
• Inflammatory factors
attack synovial
membrane
– Unchecked inflammation
can cause joint damage
(Abramson, 2013)
Pathophysiology
• Three classifications:
– Oligoarticular - 50%
– Polyarticular – 40%
– Systemic - 10%
• Criteria:
– Number of joints affected
– Symptoms
– Potential presence of antibodies
(“Childhood arthritis,” 2013)
Subjective Patient Presentation
•
•
•
•
•
•
•
limping
morning stiffness
favoring one or more limbs
inactivity
lingering fever
noticeable joint inflammation
difficulty with fine motor skills
(Abramson, 2013)
Objective Patient Presentation
• Thorough observation
(Abramson, 2013)
http://www.webmd.com/rheumatoid-arthritis/ss/slideshow-ra-overview
• May have presence of antibodies
(“Childhood arthritis,” 2013)
• Presence of elevated CRP and ESR
(“Childhood arthritis,” 2013)
Diagnosis
• Joint inflammation 6 weeks – 3 months
• Age 16 and under
• Imaging
• Rule out other childhood diseases
(Abramson, 2013)
Pharmacological Intervention
(Prince, Otten, van Suijlekom-Smit, 2011, Diagram 1, p. 98)
Non-Pharmacologic Intervention
• Initiating a multidisciplinary team to include
regular check-ups (Prince et al., 2011)
http://www.cbc.ca/news/canada/hamilton/news/report-helpshealthcare-workers-spot-fabricated-illness-in-kids-1.1304273
=http://www.knoxnews.com/news/2012/dec/01/teen-turns-herenergy-toward-fighting-juvenile/
http://my.clevelandclinic.org/childrens-hospital/specialties-services/departmentscenters/rheumatology/default.aspx
Patient Education and Counseling
• Early intervention
– Correct diagnosis
– Effective treatment
– Multidisciplinary approach
• Psychological well-being
– Child
– Parent
(Vuorimaa et al., 2009)
Conclusion
http://thecertainonesmagazine.com/juvenile-arthritis-awareness-month/
References
Abramson, MD, L. S. (2013). Arthritis in children.
Retrieved from http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Arthritis_in_Children/
Childhood arthritis. (2013). Retrieved from http://www.cdc.gov/arthritis/basics/childhood.htm
Reynolds, G. (2012). Presentation Zen: Simple ideas on presentation design and delivery (2nd ed.). Berkley, CA: New Riders.
Prince, F. H. M., Otten, M. H., & van Suijlkom, L. W. A. (2011). Diagnosis and management of juvenile idiopathic arthritis. British
Medical Journal (Overseas & Retired Doctors Edition), 342(7788), 95-102. doi:10.1136/bmj.c6434
Singh, G. (1994). Childhood health assessment questionnaire. Retrieved from
http://www.rheumatology.org/Search.aspx?SearchText=CHAQ
Vuorimma, H., Tamm, K., Honkanen, V., Konmulainen, E., Konttinen, Y. T., & Santavirta, N. (2009). Parents and children as agents of
disease management in Juvenile Idiopathic Arthritis. Child: Care, Health & Development, 35(4), 578-85.
doi:http://dx.doi.org/10.1111/j.1365-2214.2009.00981.x