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
THERE’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 being
4. Rehabilitate
- Functional assessment
- Social integration  Home Care
- Psychological support

• Rehabiliatsi:
• Merupakan tindakan untuk mengembalikan tingkat kemampuan klien
dengan R.A
 ASSESSMENT
THERE’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