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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Compromised Family Coping

Nursing Diagnosis

  • Compromised Family Coping

May be related to

  • Inadequate or incorrect information or understanding
  • Chronic disease or disability progression that exhausts the physical and emotional supportive capacity of caretakers

Possibly evidenced by

  • Expression and/or confirmation of concern and inadequate knowledge about long-term care needs, problems and complications
  • Anxiety and guilt
  • Overprotection of child

Desired Outcomes

  • Client will express feelings about the child’s chronic illness.
  • Client will identify 3 positive coping mechanisms to implement.
Nursing Interventions Rationale
Assess family’s coping methods and its effectiveness, family interactions, and expectations associated to long-term care, developmental level of family, response of siblings, knowledge and use of support systems and resources, presence of guilt and anxiety,  overprotection and/or overindulgence behaviors. Provides information revealing coping methods that work and the need to develop new coping skills and behaviors, family attitudes; child with special long-term needs may strengthen or strain family relationships and an undue degree of overprotection may be  detrimental to child’s growth and  development (disallow school attendance and peer activities, avoiding discipline of child, and allowing child to assume
responsibilities for ADL).
Encourage family members to express problem areas and explore solutions responsibly. Reduces anxiety and enhances understanding; provides the family with an opportunity to identify problems and develop problem-solving strategies.
Assist family to establish short- and
long-term goals for child and to integrate the child into family activities include the participation of all family members in care routines.
Promotes involvement and control over situations and maintains the role of family members and parents.
Assist family members to express feelings, how they deal with the chronic needs of the family member and coping patterns that help or hinder adjustment to the problems. Allows for venting of feelings to determine the need for information and support, and to relieve guilt and anxiety.
Assist family to identify positive coping mechanisms they may utilize (e.g., listening and talking about issues, family picnic, hiring a babysitter once a week, etc.). Promotes ownership of solutions to coping difficulty.
Teach family about remissions and
exacerbations of the disease and that an exacerbation may last for long periods of time (over a period of months); that exacerbations may be precipitated by overactivity, stress, presence of other illnesses, climate changes.
Provides a realistic view of the chronic nature of the disease.
Inform family that overprotective behavior may hinder growth and development, and to treat the child as normally as possible. Promotes understanding of the importance of making child one of the family and the adverse effects of overprotection of the child.
Inform parents and child of suggestions
of unorthodox cures for the disease by friends, and the harmful effects caused by some of them.
Prevents injury as well as a disappointment when cures do not measure up to expectations.
Refer to the assistance of social worker,
counselor, clergy, or other as needed.
Provides support to the family faced with long-term care of the child with a chronic illness.
Refer to community agencies and contact other families with a child with the same condition. Provides information and support to child and family.
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See Also

You may also like the following posts and care plans:

Musculoskeletal Care Plans

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Care plans related to the musculoskeletal system:

Pediatric Nursing Care Plans


Nursing care plans for pediatric conditions and diseases: 

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