The nurse is assessing a client with suspected rheumatoid arthritis. Which of the following musculoskeletal changes would contribute to a positive diagnosis? Standard Text: Select all that apply
1. Ulnar deviation
2. Bouchard's nodes
3. Heberden's nodes
4. Swan-neck deformity
5. Symmetrical loss of function in extremities
1,4,5
Rationale 1: Ulnar deviation. In rheumatoid arthritis there is chronic inflammation of the metacarpophalangeal and interphalangeal joints leading to ulnar deviation.
Rationale 2: Bouchard's nodes. The nodes that may appear on the fingers such as Bouchard's and Heberden's nodes are associated with osteoarthritis. Bouchards nodes are located on the proximal interphalangeal joints.
Rationale 3: Heberden's nodes. The nodes that may appear on the fingers such as Bouchard's and Heberden's nodes are associated with osteoarthritis. Heberden's nodes are hard, typically painless, bony enlargements associated with osteoarthritis that may occur in the distal interphalangeal joints.
Rationale 4: Swan-neck deformity. Another manifestation of rheumatoid arthritis involves what are known as swan-neck contractures. These result when the proximal interphalangeal joints are hyperextended while the distal interphalangeal joints are fixed in flexion.
Rationale 5: Symmetrical loss of function in extremities. Rheumatoid arthritis impacts the extremities symmetrically.
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