Presentation Outline  Introduction  What is Rheumatoid Arthritis?  How is it diagnosed?  Etiology and risk factors?  How is the body affected?  Progression of the disease  Interventions: Pharmacological & Non-Pharmacological  What is the role of the nurse practitioner?  Implications for the nurse practitioner  Conclusion Rheumatoid Arthritis Rheumatoid arthritis (RA) is an autoimmune disease that attacks the healthy cells in the body and causes inflammation that affects many parts of the body (CDC, 2019). The Diagnosis  Physical Assessment  Symptoms—joint pain, swelling, and stiffness  Family/Medical history  Blood testing  rheumatoid factor, ESR, CRP  Imaging  Xrays, CTs, & MRIs Etitolgoy and Risk Factors  The cause of RA is not linked to only one variable.  RA is considered an autoimmune disorder.  RA can be influenced by genetics, hormones, environmental and lifestyle habits. ("RheumatoidArthritis.org", 2020) How is it diagnosed? (Wasserman, 2018) How is the body affected?  Skin—nodules, rashes, vasculitis  Bones—decreased bone density  Eyes & Mouth—inflammation, dryness, scarring  Lungs—inflammation, scarring, nodules, pulmonary fibrosis (Badgaish et. al, 2018)  Cardiovascular System—atherosclerosis, heart attack, stroke, pericarditis, anemia, clotting issues  Liver & Kidneys—no direct damage, drug related  Nervous System—no direct damage (Badgaish et. al, 2018) Progression of the disease (Dr. Jockers, n.d.) Interventions  NSAIDs—nonsteroidal anti-inflammatory drugs (Ibuprofen, Aleve, Advil, Naproxen, Celebrex)  Steroids—corticosteroids (prednisone)  DMARDs--disease-modifying antirheumatic drugs (Trexall, Otrexup, Arava, Plaqhenil, Azulfidine) (Mayo Clinic, n.d.)  Biologic agents—biologic response modifiers (Humira, Enbrel, Remicade, etcetera)  Physical and/or occupational therapy  Surgical—synovectomy, tendon repair, joint fusion, total joint replacement