Reference no: EM133693267

Clinical case: Mrs. Rhonda Barber is a 43-year-old teacher. She visits the clinic for assessment of swelling and stiffness all over, but especially in her hands. The health history reveals that for several months Mrs. Barber 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 that she "could hardly move them." She has had no recent illness but has "felt weak and tired" and has not had much of an appetite lately. She reports no family history of musculoskeletal disease. She reports that she has had regular physical examinations including blood work, and that nothing has been abnormal. Her last exam was 6 months ago. She takes no prescribed medications but has been using Advil and Aleve for the stiffness with moderate relief. She states that she is concerned about her hands because she must write on the board and correct papers. She also fears that "if something is really wrong and I don't get relief, I won't be able to care for my family or myself for that matter." Physical assessment reveals a well-developed female 5' 3" tall, weighing 198 lbs., skin pale and warm. Her gait is steady. She has normal ROM in the upper and lower extremities. ROM of her wrists, hands, and fingers is limited. The joints of her fingers are erythematous, hot, and edematous bilaterally. Her joints are tender to touch and painful upon movement. Pain is 6 to 7 on a scale of 1 to 10. Diagnosis: The nurse suspects that Mrs. Barber may have rheumatoid arthritis. The nurse will obtain laboratory tests and X-rays.

Questions

1. As Mrs. Barber ages, what additional age-related changes will she need to be concerned about?

2. What are some strategies that would help Mrs. Barber get through the physical exam portion?