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A Brief Look at Juvenile Rheumatoid Arthritis Will Oliver, BSN, RN Lubbock Christian University

A Brief Look at Juvenile Rheumatoid Arthritis Will Oliver, BSN, RN Lubbock Christian University NUR 5200 Introduction to Graduate Studies Advanced Practice Presentation Submitted to Daniel Hatch, DNP, APRN, FNP-BC Bev Byers, EdD , RN, LMT, LMTI July 24, 2014 .

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A Brief Look at Juvenile Rheumatoid Arthritis Will Oliver, BSN, RN Lubbock Christian University

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  1. A Brief Look at Juvenile Rheumatoid Arthritis Will Oliver, BSN, RN Lubbock Christian University NUR 5200 Introduction to Graduate Studies Advanced Practice Presentation Submitted to Daniel Hatch, DNP, APRN, FNP-BC Bev Byers, EdD, RN, LMT, LMTI July 24, 2014 

  2. Juvenile Rheumatoid Arthritis • Adolescents and children, age 16 and younger(“Childhood arthritis,” 2013) • Joint inflammation and stiffness lasting 6 weeks or longer (“Childhood arthritis,” 2013) • Pediatric nursing implications

  3. Pathophysiology • Malfunction of the immune system • Following infectious disease or other unknown triggers • Inflammatory factors attack synovial membrane • Unchecked inflammation can cause joint damage (Abramson, 2013)

  4. Pathophysiology (“Childhood arthritis,” 2013) • Three classifications: • Oligoarticular - 50% • Polyarticular – 40% • Systemic - 10% • Criteria: • Number of joints affected • Symptoms • Potential presence of antibodies

  5. Subjective Patient Presentation • limping • morning stiffness • favoring one or more limbs • inactivity • lingering fever • noticeable joint inflammation • difficulty with fine motor skills (Abramson, 2013)

  6. Objective Patient Presentation • Thorough observation (Abramson, 2013) • May have presence of antibodies (“Childhood arthritis,” 2013) • Presence of elevated CRP and ESR (“Childhood arthritis,” 2013) http://www.webmd.com/rheumatoid-arthritis/ss/slideshow-ra-overview

  7. Diagnosis • Joint inflammation 6 weeks – 3 months • Age 16 and under • Imaging • Rule out other childhood diseases (Abramson, 2013)

  8. Pharmacological Intervention (Prince, Otten, van Suijlekom-Smit, 2011, Diagram 1, p. 98)

  9. Non-Pharmacologic Intervention • Initiating a multidisciplinary team to include regular check-ups (Prince et al., 2011) http://www.cbc.ca/news/canada/hamilton/news/report-helps-healthcare-workers-spot-fabricated-illness-in-kids-1.1304273 =http://www.knoxnews.com/news/2012/dec/01/teen-turns-her-energy-toward-fighting-juvenile/ http://my.clevelandclinic.org/childrens-hospital/specialties-services/departments-centers/rheumatology/default.aspx

  10. Patient Education and Counseling • Early intervention • Correct diagnosis • Effective treatment • Multidisciplinary approach • Psychological well-being • Child • Parent • (Vuorimaa et al., 2009)

  11. Conclusion http://thecertainonesmagazine.com/juvenile-arthritis-awareness-month/

  12. References Abramson, MD, L. S. (2013). Arthritis in children. Retrieved from http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Arthritis_in_Children/ Childhood arthritis. (2013). Retrieved from http://www.cdc.gov/arthritis/basics/childhood.htm Reynolds, G. (2012). Presentation Zen: Simple ideas on presentation design and delivery (2nd ed.). Berkley, CA: New Riders. Prince, F. H. M., Otten, M. H., & van Suijlkom, L. W. A. (2011). Diagnosis and management of juvenile idiopathic arthritis. British Medical Journal (Overseas & Retired Doctors Edition), 342(7788), 95-102. doi:10.1136/bmj.c6434 Singh, G. (1994). Childhood health assessment questionnaire. Retrieved from http://www.rheumatology.org/Search.aspx?SearchText=CHAQ Vuorimma, H., Tamm, K., Honkanen, V., Konmulainen, E., Konttinen, Y. T., & Santavirta, N. (2009). Parents and children as agents of disease management in Juvenile Idiopathic Arthritis. Child: Care, Health & Development, 35(4), 578-85. doi:http://dx.doi.org/10.1111/j.1365-2214.2009.00981.x

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