JIA(Juvenile idiopathic arthritis)

• often starts between 1-3 years of age
• chronic joint inflammation diagnosed prior to 16 ears of age resulting in decrease mobility, swelling, and pain
• autoimmune inflammatory disease, more common in girls
• predominately affects, large joints, however rheumatoid nodules often found in heart, lungs, eyes, and other organs
• inflamed synovial membrane, thinning of cartilage, erosion into bones, bone density loss
• s/s: limping, joint swelling and pain, swollen lymph nodes, high fever and light pink rash, unusual clumsiness, eye inflammation and other eye problems, stiffness after getting out of bed
• Nursing management: relive pain, control inflammation, manage systemic complications, preserve joint function and range of motion
• Nursing management: physical and occupational therapy:

  • ROM and muscle strengthening excercises are ordered and carries out by a physiotherapist
  • bed rest should be avoided unless in most acute stage
• involvement of the eye should be followed and treated by an ophthalmologist
• NSAIDS first
• NSAIDS used to decrease inflammation(ibuprofen)
• aspirin should not be used in children due to developing Reye's syndrome
• if NSAID fails alternative medications may be used: methotrexate
• occasionally local corticosteroid injections or joint replacement is required
• systemic corticosteroid injections are not routinely used due to the high risk of side effects
• antimetabolite: Methotrexate, immunosuppressant for cancer and autoimmune disorders
• Methotrexate: adverse effects: diarrhea, n/v, increased liver enzymes, rash
• Methotrexate contraindication: renal function