learning Objectives - Describe the management of clients with connective tissue and collagen disorders Demonstrate skill in providing nursing care to clients with connective tissue and collagen disorders
Hours - 8
Teaching and Learning Activities - Lecture cum discussion Clinical teaching
Assessment Methods - Short answer Objective type Essay type
Content of the chapter
a) Assessment
– History
– Physical examination
– Diagnostic measures
b) Management of patients with disorders of
connective tissue and collagen disorders
– Rheumatoid arthritis
– Systemic lupus Erythematosus (SLE)
– Scleroderma
– Polymyositis
– Osteoarthritis
– Ankylosing Spondylitis
– Gout
– Fibromyalgia
c) Alternate therapies
d) Drugs used in treatment of connective tissue
and collagen disorders
Nursing Management of Patients with Connective Tissue and Collagen Disorders
Connective tissue and collagen disorders are chronic inflammatory or degenerative conditions affecting joints, muscles, skin and internal organs. Nursing management focuses on assessment, pain relief, maintenance of mobility, prevention of deformities, and patient education.
a) Assessment
1. History
- Joint pain, stiffness and swelling
- Duration and pattern of symptoms
- Morning stiffness
- Muscle weakness or fatigue
- Skin changes (rash, thickening)
- Fever, weight loss
- Family history of autoimmune disorders
- Drug history and response to treatment
- Effect on daily activities
2. Physical Examination
- Inspection:
- Joint swelling, redness, deformities
- Skin rashes (malar rash in SLE)
- Palpation:
- Tenderness, warmth
- Range of motion:
- Active and passive movements
- Muscle strength assessment
- Posture and gait
- Presence of nodules or tophi (gout)
3. Diagnostic Measures
- Blood tests:
- ESR, CRP
- Rheumatoid factor (RF)
- Anti-CCP
- ANA, anti-dsDNA (SLE)
- Serum uric acid
- X-ray of affected joints
- MRI / CT (if needed)
- Muscle biopsy (polymyositis)
b) Management of Patients with Connective Tissue and Collagen Disorders
Rheumatoid Arthritis
- Pain management
- Rest during acute phase
- Exercise to maintain joint mobility
- Splinting to prevent deformities
- Patient education on joint protection
Systemic Lupus Erythematosus (SLE)
- Avoid sunlight
- Manage fatigue
- Monitor renal and cardiac status
- Infection prevention
- Psychological support
Scleroderma
- Skin care and moisturization
- Prevent cold exposure
- Monitor swallowing and breathing
- Gentle stretching exercises
Polymyositis
- Monitor muscle strength
- Assist in mobility
- Prevent aspiration
- Physiotherapy
Osteoarthritis
- Weight reduction
- Heat therapy
- Strengthening exercises
- Assistive devices
Ankylosing Spondylitis
- Posture exercises
- Deep breathing exercises
- Firm mattress
- Pain relief measures
Gout
- Pain relief during acute attack
- Encourage hydration
- Low-purine diet
- Joint rest
Fibromyalgia
- Stress management
- Regular low-impact exercise
- Sleep hygiene
- Emotional support
c) Alternate Therapies
- Physiotherapy
- Yoga and stretching exercises
- Hydrotherapy
- Massage therapy
- Relaxation techniques
- Heat and cold therapy
d) Drugs Used in Connective Tissue and Collagen Disorders
- NSAIDs: Ibuprofen, Diclofenac
- Corticosteroids: Prednisolone
- DMARDs: Methotrexate, Sulfasalazine
- Biological agents: Etanercept, Infliximab
- Antimalarials: Hydroxychloroquine (SLE)
- Uric acid lowering drugs: Allopurinol
- Muscle relaxants: Cyclobenzaprine
- Analgesics: Paracetamol
Conclusion
Nursing management of connective tissue and collagen disorders emphasizes early assessment, pain control, maintenance of function, prevention of disability, and long-term patient education. Holistic nursing care improves mobility, independence and quality of life.