Refferal Case Study for Rheumatoid Arthritis free essay sample

Is an autoimmune disease which can cause chronic inflammation of body`s organs, joints, and the surrounding tissue of the joints. It can be defined as: â€Å"a disease of synovial tissue, i. e. a joint linings, tendons, tendon sheaths and associated structure. So widespread is the inflammatory process that inflammatory nodules may form almost anywhere, the extensor surfaces of the limbs being most common, such as elbow and forearm nodules, but nodules may also form in the lungs and other visceral tissue† (Wright Foundation Exercise referral manual, 2008) The onset of Rheumatoid Arthritis is generally between 45-65 years (Stenstrom Minor, 2003) Specific inclusion criteria –Mild to moderate severity Specific exclusion criteria – Severe severity Depression – â€Å"An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. Without treatment, symptoms can last for weeks, months, or years. We will write a custom essay sample on Refferal Case Study for Rheumatoid Arthritis or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page † (http://www. medterms. com/script/main/art. asp? articlekey=2947) Specific inclusion criteria –Mild to moderate severity Specific exclusion criteria – Severe severity Additional Information As the client is 66 years of age she will be considered as elderly. Elderly – Whilst aging there is a steady functional decline, cardio-vascular, flexibility and strength. Reduction in functionality could be a possible cause of depression due to a reduction of independence and possible social isolation. (Wright Foundation Exercise referral manual, 2008) Medication Drug: Aceclofenac Drug group: Non steroidal anti-inflammatory drugs (NSAID) Reason for Prescription: Rhematoid Arthritis Desired effect: â€Å"It works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced in response to injury or certain diseases and would otherwise go on to cause pain, swelling and inflammation. Arthritic conditions are one example of this. Aceclofenac is used to relieve pain and inflammation in arthritic condition† (http://www. tiscali. co. uk/lifestyle/healthfitness/health_advice/netdoctor/archive/100004233. tml) Possible side effects: Nausea, Gastro-intestinal discomfort, diarrhoea, hypersensitivity reactions (particularly rashes, angioedema, and bronchospasm headache, dizziness, nervousness, depression, drowsiness, insomnia, vertigo, hearing disturbances such as tinnitus, photosensitivity, and haematuria. Blood disorders have also occurred. Fluid retention may occur (rarely precipitating congestive heart failure); blood pressure may be raised. (http://www. bnf. org. uk/bnf/bnf/current/5183. htm#_5183. 9) Possible effects of drug during exercise: Dizziness during transitions, Bronchospasm during exercise, vertigo can effect balance, photosensitivity may cause skin irritation if outdoors in the sun and hearing disturbances may affect communication. Implications of exercise prescription: Avoid transitions, implement intervals allowing for toilet breaks, if physical activity is outdoor then advise on suitable weather conditions and ensure that instructions are well communicated and understood. Drug: Nortriptyline Group name: Tricyclic antidepressants (TCA) Reason for Prescription: Depression Desired effect: â€Å"When depression occurs, there may be a decreased amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood. Nortriptyline works by preventing this re-absorption of noradrenaline and serotonin back into the nerve cells. Therefore, it helps prolong the mood-lightening effect of any released noradrenaline and serotonin†. (http://www. tiscali. co. uk/lifestyle/healthfitness/health_advice/netdoctor/archive/100003239. tml) Possible side effects: â€Å"dry mouth, sedation, blurred vision (disturbance of accommodation, increased intra-ocular pressure), constipation, nausea, difficulty with micturition; cardiovascular side-effects (such as ECG changes, arrhythmias, postural hypotension, tachycardia, syncope, particularly with high doses); sweating, tremor, rashes and hypersensitivity reactions (including urticaria, photosensitivity), behavioural disturbances (particularly children), hypomania or mania, confusion or delirium (particularly elderly), headache, interference with sexual function, blood sugar changes; increased appetite and weight gain (occasionally weight loss); endocrine side-effects such as testicular enlargement, gynaecomastia, galactorrhoea; also convulsions (see also Cautions), movement disorders and dyskinesias, dysarthria, paraesthesia, taste disturbances, tinnitus, fever, agranulocytosis, leucopenia, eosinophilia, purpura, thrombocytopenia, hyponatraemia abnormal liver function tests.