4 Juvenile Rheumatoid Arthritis Nursing Care Plans

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Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis (JIA), is a chronic inflammatory disease that primarily affects the synovium of the joints resulting in effusion and eventual erosion and destruction of the joint cartilage.

JRA is categorized into different classification and manifested by remissions and exacerbations with the onset usually occurs between ages 2 to 5 and 9 to 12 years old. Pauciarticular arthritis is the most common form of JRA that involves 4 or fewer joints; polyarticular arthritis involves many joints, usually more than four. Systemic arthritis involves the presence of joints swelling, and associated fever, light-pink rash, and affect internal organs such as the heart, lungs, eyes, liver, spleen, and lymph nodes.

Prognosis is based on the type of arthritis, the severity of the disease, and response to treatment with the most severe complications of permanent deformity, hip disease, and iridocyclitis with visual loss.

Nursing Care Plans

Nursing care planning goals for a child with juvenile rheumatoid arthritis aims to provide relief of pain, improve coping ability, preserve muscle and joint function, prevent joint deformity, promote positive body image, and increase confidence in the performance of self-care activities.

Here are four (4) nursing care plans (NCP) and nursing diagnosis for juvenile rheumatoid arthritis (JRA):

  1. Chronic Pain
  2. Self-Care Deficit
  3. Disturbed Body Image
  4. Compromised Family Coping
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Self-Care Deficit

Self-Care Deficit: Impaired ability to perform or complete activities of daily living for oneself, such as feeding, dressing, bathing, toileting.

Nursing Diagnosis

  • Self-Care Deficit: Bathing/Hygiene, Dressing/Grooming, Feeding, Toileting

May be related to

  • Pain
  • Discomfort
  • Musculoskeletal impairment

Possibly evidenced by

  • Inability to perform ADL and to maintain complete physical care
  • Immobility status
  • Pain and weakness of joints and intolerance to activity
  • Joint deformity and/or contractures

Desired Outcomes

  • Child will perform self-care within limits of illness.
Nursing InterventionsRationale
Assess abilities and level of care and assistance.Provides information about the child’s ability to do self-care and to observe improvement.
Allow the child to perform own care and commend any completed actions.Provides a sense of independence and fulfillment; motivates to continue progress in ADL.
Support as much independence in doing activities of daily living as possible but provide assistance when needed.Promotes self-sufficiency and control over daily personal care needs without damage to joints.
Position items and objects used for care within reach; provide physical child aids/devices to assist in the performance of ADL (cane, wheel-chair, easy-to-grip knobs, clothes with button hooks, or Velcro closures, sock aids and zipper pulls etc.).Promotes self-reliance and allows easy access to aids to improve independence.
Assist parents and child to develop plan and goals for daily ADL and to include interventions formed by a physical and occupational therapist.Promotes independence and compliance in self-care.
Instruct parents and child about the application and use of aids and self-confidence.Promotes independence in ADL and devices to accommodate self-care activities.
Discuss possible changes or modifications in the home and school environment to support child’s independence in meeting physical needs (pathways, furniture, doors).Allows for safe participation in activities that are usually carried out by the child on a daily basis.
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See Also

You may also like the following posts and care plans:

Musculoskeletal Care Plans

Care plans related to the musculoskeletal system:

Pediatric Nursing Care Plans


Nursing care plans for pediatric conditions and diseases: 

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