Assignment Task

Case History:

Barbara is a 58-year-old woman who you see whilst working in the Curtin clinic. Barbara is married and lives with her husband Clive. Their two daughters are now young adults and live abroad. Barbara works part-time in a real estate office and enjoys craft activities, bushwalking, and swimming.

Past Medical History

Appendicectomy aged 20 years

Medications

Paracetamol 1g QID or Ibuprofen 400mg QID prn for pain

Vital signs

Weight 72kg, Height 165cm.

Temperature 36.2 ◦C

Respiratory Rate 18 breaths/min.

Pulse 70 beats/min, regular pulse.

Blood Pressure 124/76 mmHg

SaO2 99% on room air

Pain score = 5/10

Clinical Presentation:

You are on clinical placement as a Student RN and see Barbara in the Curtin clinic. For the past 6 months, Barbara has been experiencing stiffness in both hands in the morning. Pain score 5/10 which is impacting her usual daily activities at home and work. She also reports tenderness and swelling in her finger joints. The stiffness experienced is now lasting more than 1 hour every morning and includes her hands, wrists and ankles. She also has increasing difficulty standing for long periods at work or at home due to foot and ankle pain. She began taking ibuprofen 400mg up to 4 times daily and found it helps her get through her day with less pain and stiffness, but it is still a concern. Three months ago, she also began feeling extremely tired which is impacting her energy levels.

Barbara does not smoke but does drink alcohol, 1-2 standard drinks of wine 2 times per week. She has a positive family history of Rheumatoid Arthritis. Barbara is referred to her treating General Practitioner and a Rheumatologist for further tests and she is diagnosed with Rheumatoid Arthritis.

INTEGRATED CASE STUDY REPORT QUESTIONS:

Please Answer The Questions Below, In Relation To The Case Study Provided

You must use the following Journal to assist in answering the case study questions. Three articles must be referenced from the below journal. The Journal can be accessed from the Curtin Library: Arthritis Care and Research

Focus Area One – Aetiology and pathophysiology

1. Define Rheumatoid Arthritis and outline the aetiology and risk factors for Rheumatoid Arthritis.

2. Describe the pathophysiology of Rheumatoid Arthritis.

3. Relate Qu 1 and Qu 2 to the case study of Barbara provided.

Focus Area Two – Clinical manifestations and clinical assessment.

4. Describe the typical clinical manifestations (signs and symptoms) of Rheumatoid Arthritis.

5. Outline the clinical assessment and diagnosis of a patient presenting with Rheumatoid Arthritis- Include patient history, physical examination, tests and any diagnostic processes/ screening tools used.

6. Relate Qu 4 and Qu 5 to the case study of Barbara provided.

Focus Area Three – Evidence-based approaches and potential complication

7. Outline recommended evidence-based management strategies for treating Rheumatoid Arthritis – pharmacological and non-pharmacological.

8. Discuss in brief ONE potential complication of Rheumatoid Arthritis that Barbara may experience.