Sarah has self-identified person-centred care needs. Choose one [1] of
Image transcription text Question 3: Explain what is happening in the body to cause Sarah’s swollen joints. One Paragraph (200 + 10%) Content for your 200-word paragrap… Show more Case Study: Clinical Presentation Sarah Jones is a 62 year old female who considers herself reasonably healthy, but she has been experiencing some pain in the joints of her fingers for a few years, and now has pain in both wrists and her hips. She attributes the pain in her hands to her many years of work as a secretary and her increased needlework, particularly quilting and embroidery since retiring. Lately Sarah has been finding it increasingly difficult to use her hands and her fingers in both hands are stiff first thing in the morning, often for over an hour. Due to this she regularly has difficulty buttering her toast, doing up the buttons on her clothes and putting on her bra. Sarah has noticed that her fingers look swollen and not right and she is not sleeping properly, so she visits her local general practitioner because paracetamol and ibuprofen do not seem to be helping anymore. b.Joint pain, difficulty sleeping, swollen joints, difficulty with daily activities. Sarah has an occasional glass of wine at special celebrations, she smoked cigarettes for about 25 years when she was younger but stopped smoking over 20 years ago. Her blood pressure has been in the high-normal classification during the past year and Sarah has been managing it with diet and exercise. Sarah’s father had rheumatoid arthritis and the doctor suspects that Sarah has arthritis so orders tests to investigate the type of arthritis she likely has. c.pannus formation and fusion of the joints in her hands/fingers which causes joint immobility. Considering Sarah’s health history, risk factors, clinical manifestations, blood, antibody and genetic test results, and her x-ray she was diagnosed with rheumatoid arthritis. Sarah is 162 cm tall, 69 kg with a BMI of 26.3 kg/m2. Her vital signs are: temperature 36.4â° C, heart rate 74 beats/min, respiration rate 16 breaths per minute, blood pressure 128/84 mmHg. Blood tests were conducted to check her full blood count Antibody tests were conducted to determine Sarah’s rheumatoid factor and anti-citrullinated peptide/protein antibody levels as well as an antinuclear antibody (ANA) assay. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were both elevated. Rheumatoid factor (RF) and anti-citrullinated peptide/protein antibodies (ACPA) were both positive. ANA results confirmed presence of autoantibodies. Genetic testing is positive for human leukocyte antigen DRB1 (HLA-DRB1) X-rays were taken of Sarah’s hands which indicate a mild deformity at numerous proximal interphalangeal joints of the fingers on both hands.
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