Thursday, October 17, 2019

The Standards of Care of a Patient with Rheumatoid Arthritis Essay

The Standards of Care of a Patient with Rheumatoid Arthritis - Essay Example Proliferation of the synovial membrane and uncontrolled persistent inflammation are the characteristic features of RA which manifest as a symmetric arthritis affecting several small and large joints. Other symptoms include fatigue, articular stiffness, anorexia and fever. Complaint of pain and limited lifestyle are the characteristic features of the onset of the disease. If left untreated, the inflammation will result in serious life threatening conditions during its progression. Morbidity, progressive disability and hastened mortality feature the untreated disease conditions. As a result, it entails serious economic implications for both the patients and their families as well as society as the affected people are unable to continue in their employment with the same efficiency as before with their normal functioning of their palms, feet and gait seriously affected and progressively disfigured and disabled (Cush, Weinblatt, & Kavanaugh, 2010). According to National Audit Office, ther e are around 580,000 people afflicted with RA with additional 26,000 new cases every year. The disease affects people of age between 40 to 60 years with women who are three times more likely to be affected than men. The patient referred herein for treatment also happens to be a woman aged 40. This being an auto-immune disease, affects small joints of the hand and feet. If severe, it reduces life expectancy by 6-10 years as a result of co-morbidity through cardio-vascular diseases or side effects from treatment (Home & Carr, n.d.) The disease reduces the affected person’s work life by five years. Its annual cost to the U.K. economy is estimated to be between ? 3.8 and ? 4.75 billion (NationalAuditOffice, 2009). There are many institutions engaged in the care of RA with their own guidelines for treatment. British Society for Rheumatology (BSR, (n.d)),NHS (NHS, n.d.), National Rheumatoid Arthritis Society (NRAS) (NRAS, n.d.), The Society of Chiropodists and Podiatrists (SCPOD, n .d.), The Musculoskeletal Services Framework (DeptOfHealth, 2006), NSF long-term conditions (DeptOfHealth, Department of Health, 2005), 18 week commissioning pathway (DeptOfHealth, Department of Health, 2006) and Podiatry rheumatic care associations (PodiatryRheumaticCareAssociation, n.d.) are the major sources of standards of care for RA conditions. They are complementary to one another and it is worthwhile referring to all of them while dealing with the patient affected by RA. Brief outline of care Two of the inevitable symptoms RA are joint pain and stiffness that manifest in the foot and ankle in the early stages. These symptoms also change during the course of progression of the disease (Helliwell, 2006). Since rheumatoid arthritis is not curable, the aim of care is to relieve symptoms and improve quality of life for the patient. Although multidisciplinary approach is resorted to, therapeutic interventions are the responsibility of rheumatoid specialist professionals. The patie nt involvement and empowerment are desirable for a successful outcome with the patient coping up with the course of treatment and lifestyle adaptations (Alexander, Fawcett, & Runcinman, 2006). For control of pain, analgesics such as paracetamol/aspirin, compound analgesics such as cocodamol to NSAIDs can be administered. Since NSAIDs are associated with gastrointestinal side-effects, cyclo-oxygenase (Cox) II group of NSAIDs are recommended so that side effects are at minimal levels. (Alexander, Fawce

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