Question

Mrs. H, age 42 years, is experiencing severe rheumatoid arthritis in her wrists, fingers, and knees. The joints are quite inflamed, red, and swollen. She is sitting rigidly in a chair and refuses to put on a sweater, even though she is shivering, or let anyone touch her arms. She has been prescribed an analgesic and an anti-inflammatory drug, but her dose is not due for another hour. She is feeling nauseated, so she has not eaten for the past 8 hours.

Discussion Questions

1.      Based on patient history and the signs and symptoms, discuss how the effects of pain are exacerbating her condition.

2.      Explain why Mrs. H is “cranky” and uncooperative. What interventions other than medication may help her tolerate the pain?

            3.      Discuss in what category of pain this patient’s condition may be classified, acute or chronic.

            4.      Discuss the potential treatment strategies and mechanisms involved to relieve the pain being experienced by the patient.

Answer 1

1.The rheumatoid arthritic pain is generally a sharp ,pricing or squeezing in nature.Even a mild movement of the joint can cause a pain which is similar to a fracture.The pain has led this women not to do her daily activity, slight movement causing pain resisted her from wearing the sweater. She is psychologically disturbed that even touch can be painful.The effect of medication has further contributed to nausea and avoiding food.

2.She is cranky because of the excruciating pain.The intervenion other than medication are

• Hot or cold application which can dilate and construct blood vessel respectively can reduce the pain
• Yoga ,meditation to relax herself
• Chiropractic can help her to be relieved of the pain and improve her quality of life
• Mild exercise can relieve her rigidity and provide relief overtime
• Acceptance and commitment therapy is the most recent practice in pain management

3.Rheumatic pain is a chronic classification because the pain may reoccur even after treatment in later days.

4.The potential treatment strategy for this patient are

• Medication:
  • Analgesic to relieve pain
  • NSAID to relieve inflammation along with pain
  • Immunosuppressive therapy to relieve the root cause
• Exercise
  • Mild exercise which can activate the muscles and bones yo be encouraged
• Surgery
  • The removal of synovial fluid called as arthrocentesis can be performed
  • Joint replacement if no medication relieves the patient
• Others
  • Diversional therapy
  • Hot application can relieve the muscle construction and thus alleviating the pain