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  Rheumatoid Arthritis Patient Education Activity A 48-year old female presents stiffness in both hands in the morning for last 7 months. Stiffness now lasted more than 1 hour every morning and includes hands, wrists and ankles. She also had increasing difficulty standing for long periods at work or at home due to foot and ankle pain. She began taking ibuprofen 800mg 3 times daily and found it helped her get through her day with less pain and stiffness. Three months ago, Joy noticed pain in her right and left shoulders when she would cut or blow dry her client’s hair.  She also began feeling extremely tired and short tempered. She had no energy to do her usual activities. Ibuprofen was no longer very effective for her pain or stiffness. One morning, Joy could not lift her arms at all without extreme shoulder pain. She knew it was time to get help. Pt is married with 3 teenagers, and works part time as a hairdresser. Dx: Rheumatoid Arthritis (RA) Rx:  methotrexate, Physical Therapy You are providing the patient with education on her new diagnosis. Create a patient teaching plan that covers the following questions.  1.  What is rheumatoid arthritis?  2.  What are the important teaching points for her medication?  3.  What are the recommendations to manage her joint pain during remission?  During exacerbation?                                                                                  ANOTHER CASE STUDY SLE Lupus Patient Education Activity A 20-year old female presents with chief complaint of fatigue, anxiety, and heart palpitations. She has recently given birth to her second child, a daughter. Initial recommendation from her follow up appointment is to rest. The patient’s symptoms worsen and then gradually resolve. Over the next year she has increased fatigue and headaches. She also starts to complain of joint pain in her ankles, knees, elbows, wrists, and fingers. Rest and over-the-counter pain medication relieve her symptoms, but it is difficult for her to find time for much rest due to the responsibilities of caring for a family and working full-time. The winter brings a new intolerance to low temperatures. She states her hands and feet becoming painful and discolored when she is exposed to cold. Her extremities became painful, stiff, and altered in color when exposed to cold temperatures. She also develops a butterfly rash. DX: systemic lupus erythematosus. Rx: prednisone and hydroxychloroquine You are providing the patient with education on her new diagnosis. Create a patient teaching plan that covers the following questions. 1.  What is lupus? 2.  What key lifestyle changes will the patient need to address to manage her condition? 3.  What are the important teaching points for her medications? 4.  What are the recommendations to manage her symptoms, to avoid flare-ups, and to monitor her condition? 5.  What symptoms, if they occur, should she report immediately to her provider and why?  

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