A nurse is caring for a client who has been recently diagnosed with rheumatoid arthritis (RA). Which assessment finding does the nurse expect to assess?.
A Symmetrical joint pain that is relieved with rest.
B Symmetrical joint pain.
C Bouchard’s nodes in the middle joints.
D Unilateral pain in the weight-bearing joints.
The Correct Answer and Explanation is:
The correct answer is B. Symmetrical joint pain.
Explanation:
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects the joints. One of the hallmark features of RA is its symmetrical pattern of joint involvement. This means that RA typically affects the same joints on both sides of the body, a characteristic that helps distinguish it from other types of arthritis.
Here’s a breakdown of why B is the correct answer and why the other options are less accurate:
- Symmetrical joint pain: RA commonly presents with symmetrical joint pain, which means if one joint is affected, its counterpart on the opposite side is usually affected as well. This symmetrical pattern is a distinguishing feature of RA compared to other forms of arthritis, such as osteoarthritis, which often affects joints asymmetrically. The symmetrical pain is due to the systemic nature of RA, which involves widespread inflammation throughout the body.
- Symmetrical joint pain that is relieved with rest: While RA does involve symmetrical joint pain, this pain is not typically relieved with rest. In fact, RA pain can persist despite rest and may be exacerbated by inactivity. RA pain is often most severe in the morning after rest and may improve with movement as the day progresses.
- Bouchard’s nodes in the middle joints: Bouchard’s nodes are osteophytes (bone spurs) that form on the proximal interphalangeal joints (PIP) of the fingers and are associated with osteoarthritis, not RA. RA more commonly affects the metacarpophalangeal joints (MCP) and may cause swelling and deformity in these joints, rather than Bouchard’s nodes.
- Unilateral pain in the weight-bearing joints: RA usually does not present with unilateral joint pain. Instead, it affects joints bilaterally. Additionally, while RA can affect weight-bearing joints, such as the knees, it does so symmetrically, and unilateral pain is more characteristic of other conditions like osteoarthritis or injury.
In summary, the most consistent and expected finding in a client with RA is symmetrical joint pain. This symmetrical pattern helps in diagnosing RA and differentiating it from other types of arthritis.