Rheumatoid Arthritis Basics
What type of disorder is RA?
A chronic, systemic, progressive inflammatory autoimmune disorder
List 3 manifestation of RA
fatigue, low-grade fever, weight loss, depression, anemia
What is the purpose of DMARDs?
to modify the immune and inflammatory response and slow disease progression
What cells does HIV target?
CD$ helper T cells
What is the main goal of antiretroviral therapy (ART)?
Suppress viral replication, prolong life, and prevent opportunistic infections
What tissue is primarily affected in RA?
Connective tissue
(although it can also affect multiple organs)
Which joints are commonly affected?
Hands, wrists, elbows, knees, ankles, and cervical spine
Why should you never abruptly stop corticosteroids?
Sudden discontinuation can cause adrenal insufficiency and flare ups
What is the difference between HIV and AIDS?
HIV is the virus; AIDS is the final stage of HIV w/ CD4 <200 and opportunistic infections
What is PrEP and who must use it?
Pre-exposure prophylaxis; HIV-negative people that are at a high-risk for exposure
What is the typical pattern of joint involvement in RA?
Symmetrical & polyarticular
What CV risk is increased in RA patients?
CAD due to chronic inflammation
What are the main goals of non-pharm management?
Reduce pain, preserve function, prevent deformity, and maintain mobility
What is seroconversion?
The period when HIV antibodies become detectable (~6 weeks–6 months)
What is PEP and when must it be started?
Post-exposure prophylaxis; must start within 72 hours after potential exposure and must be taken for 28 days
What causes RA?
Exact cause unknown. Likely combination of:
How do autoantibodies (rheumatoid factor) contribute joint damage?
They form immune complexes that trigger inflammation and destroy tissue
List teaching of NSAID use in RA.
Take with food to reduce GI upset, monitor for nephrotoxicity, avoid in renal, cardiac, or liver disease
Name the most common opportunistic infection in AIDS.
Pneumocystis jirovecii pneumonia (PCP)
Why should HIV-positive pregnant women avoid breastfeeding?
To prevent vertical transmission of HIV to the infant
What is a pannus in RA?
Abnormal tissue with new blood vessels that destroy cartilage and bone
What types are deformities are common in RA?
Swan-neck deformity: Hyperextension of PIP joints with flexion of DIP joints
Boutonnière deformity: Flexion of PIP with extension of DIP
Ulnar deviation due to joint destruction
Why is PT and OT important?
To maintain joint function, improve mobility, and prevent deformities
What is the window period?
The time after infection when HIV tests may be negative but the person is still infectious
Name 2 nursing interventions for patients with HIV/AIDS.
Medication adherence support and infection prevention education