K.R., a 42-yr-old married white woman, comes

K.R., a 42-yr-old married white woman, comes to the rheumatology clinic with tenderness and pain in the small joints of her hands. Subjective Data Reports tenderness, joint pain, and stiffness in her hands for the last 3 mo Having fatigue, anorexia, and morning stiffness Mother diagnosed with ankylosing spondylitis 8 yr ago Expresses doubt about her ability to manage the disease Objective Data Physical Examination Swelling, warmth, and tenderness of third and fourth metacarpophalangeal joints of both hands Mild pain with neck motion Tenosynovitis Diagnostic Studies Positive ESR, RF, and anti-CCP Mild bone demineralization present bilaterally in hand x-rays Interprofessional Care Diagnosed with RA Started on methotrexate 7.5 mg PO once per week, etanercept (Enbrel) 50 mg subcutaneously once per week, prednisone 10 mg/day Discussion Questions How will you explain the pathophysiology of RA to K.R.? K.R. asks you if genetic factors are related to a diagnosis of RA. How will you respond? Based on the assessment data presented, what are the priority nursing diagnoses? Why is an exercise program important in the treatment plan for K.R.? SCIENCE

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