Reference no: EM133661110

Case: Miss Warner is a 43 year old Caucasian teacher who present for evaluation of swelling and stiffness all over, but especially her hands. She reports for several months she has had some stiffness in her joints when awakening from sleep and after long periods of physical activity "like housework". She became alarmed when her hands were "hot, red, and swollen" and she could barely "move hands". She denies recent illness, but does report she feels "weak and tired" and her appetite is decreased. She reports she has had regular annual physicals and blood work and no abnormalities found. Last physical examination 6 months ago. She takes no prescribed medications, but has been using Advil and Ibuprofen as needed for stiffness with moderate relief. She reports she must write on the board and correct papers and the stiffness to her hands is affecting her ability to does these things.

Objective data: 5'3 inches tall, weight 120 pounds. Skin pale and warm. Gait steady. Normal range of motion in upper and lower extremities. Range of motion of wrists, hands, and fingers is limited. Joints of fingers are erythematous, hot, and edematous bilaterally and are tender to touch. Pain is 7 on 1-10 scale.

Question 1: What information would be helpful in developing a plan of care for Miss Warner?

Question 2: How would the nurse discriminate between the findings for rheumatoid arthritis and osteoarthritis?

Question 3: Describe the thoughts of the nurse that led to the suspicion of rheumatoid arthritis?