Juvenile Idiopathic Arthritis

Definition: This is an autoimmune inflammatory disease of the joints.

Signs and Symptoms: Joint pain, swelling, and limited range of motion are seen.

Diagnostics: X-rays and increased erythrocyte sedimentation rate levels.

Complications: Disability and acute uveitis can cause blindness.

Drug Therapy: NSAIDs, methotrexate, corticosteroids, and slow-acting antirheumatic drugs (SAARDs) are administered.

Nursing Care: Treat each symptom individually. Administer medications as ordered. Maintain proper pain management. Regular eye exams are done routinely. Assess joint for swelling or tenderness. Hot and cold therapy can decrease discomfort. Physical therapy is needed. Provide emotional support.

Duchenne Muscular Dystrophy (DMD)

Definition: Pseudohypertrophic (Duchenne) muscular dystrophy is the most common muscular dystrophy disorder in children. DMD is caused by an absence of the protein dystrophin, which results from a genetic defect on the X chromosome.

Signs and Symptoms: Unsteady gait, falls easily, hip/knee contractures, scoliosis, postural changes, cognitive difficulty, obesity, muscles enlarged on the thighs and upper arms, and weakened calf muscles.

Diagnostics: Muscle biopsy, electromyography (EMG), DNA testing, and serum creatine kinase (CK) is elevated.

Complications: Cardiac and respiratory failure can occur if left untreated.

Drug Therapy: Prednisone can be used to decrease loss of muscle function.

Nursing Care: There is no cure for DMD. The main intervention is to maintain ambulation and range of motion. To maintain muscle function braces, physical therapy, weight control, and stretching exercises are helpful. Maintain a safe environment for the child since falling occurs frequently. Maintain respiratory function by using an incentive spirometer. Family and patient support is needed.

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