Raynaud's Phenomenon Analysis

She has also been taking Minocin for rosacea, 50 mg twice weekly. She has been on higher doses of Tetracycline in the past with out problem.

The working diagnosis is that this patient is suffering from Angioedema as a result of Anaphylaxis and developing Urticaria. Angioedema is the swelling of deep layers of the skin due the accumulation of fluid, symptoms of Angioedema include swelling of the eyes, lips, hands and feet.

Rheumatoid Arthritis(RA) is the most common type of autoimmune arthritis. RA is a progressive and debilitating musculoskeletal disorder that affects the joints symmetrically, causing a range of systemic effects. What it causes is still not well known; nevertheless, findings of new research points towards a believe that it is triggered by a defective immune system, which causes the release of inflammatory chemicals. These chemicals cause damage to cartilage and bone, usually affecting the wrists, the joints of the hand, including the knuckles, the middle joints of the fingers and feet. While this condition can affect any joints, besides, important body organs such as the eyes and the lungs can also be affected by the inflammation that occurs as a result of this chronic condition. Only in America 1.3 million of people are affected by this ailment, and 75 % of them are mainly women. Its onset usually occurs between fourth and sixth decades; however, RA can occur at any age("Diseases And

• People who do repetitive motions with their hands, such as movements in sports or heavy labor.

In order to establish a treatment, plan it is important to set goals for this patient. In general goals for RA include early recognition and diagnosis, referral to a rheumatologist, and tight control and low disease activity (Cohen & Cannella, 2017). There are also scales that need to be completed by the NP and patient to determine how the treatment is working for a patient. When setting goals, it is important to determine a successful way to evaluate this patients' pain. In the older population it is common for pain to be under treated and part of the cause of this is because the assessment for pain is not matching the patients' needs. Once a successful evaluation has been chosen for this pain it would be important to use this same

Patient denies history of skin disease. Reports two serious sun burns while swimming and not re-applying sun screen. Reports occasional dryness of skin during the winter. Denies any

Finger or toes that turn white or blue when exposed to cold or when stressed (Raynaud's phenomenon)

Raynaud’s disease is when the body restricts the amount of blood flow to various parts of the body, such as the hands and feet. There are some factors that contribute to making this disease worse, but there are also some factors that can help in making this disease more controllable. With the very few known facts about Raynaud’s disease, it is not a disease that should be overlooked for the fact it affects “approximately five to ten percent of Americans.” (WebMD, 2005-2016).

She states it had been causing her pain for a couple of days and the pain got unbearable. DG has a medical history of stroke, encephalopathy, cataracts and macular degeneration, COPD with chronic respiratory failure, type 2 diabetes, peripheral vascular disease, neuropathy, and GERD. The client also has a surgical history of cataract removal, hysterectomy, angioplasty (2011), sixth toe amputation, and right, above the knee amputation performed in April of 2017. DG has no known allergies.

Acute idiopathic blue finger is a benign and rare condition. It is characterised by an acute bluish discoloration of fingers which may be accompanied by pain4. The acute blue finger appears to occur in all age groups, predominately affecting the female, middle-aged population1. Spontaneous acute blue finger syndrome is an entity different from ischemia or vasospasm. The mechanism of subcutaneous bruising has been offered. Lesions usually disappear without the stages of ecchymosis resorption. The patients presenting with acute blue fingers should be rapidly clinically evaluated. The absence of any thromboembolic disorders or systemic diseases indicates a benign clinical course2. In a prospective follow-up of 22 patients who had presented with

"Rheumatoid joint inflammation is an interminable infection set apart by irritation of the joints, frequently influencing the hand joints and both sides of the body in the meantime" (Royal Australian College of General Practitioners, 2009).

Cutaneous small vessel vasculitis (CSVV) is synonymous with cutaneous leukocytoclastic vasculitis (LCV) and refers to involvement of the postcapillary venules of the dermis by intense neutrophilic vascular inflammation. Clinical studies of colchicine in CSVV shown mixed results. In a prospective, randomized controlled trial involving 41 patients, colchicine had no statistically significant therapeutic effect [4]. In contrast, case series and case reports have suggested that colchicine can be effective [2,3]. So, oral colchicine (0.6 mg two to three times daily) is one of the first-line therapy for mild recurrent or persistent CSVV. Initial signs of response are typically observed within 1 to 2 weeks [13,14].

Few people are aware of Raynaud's disease even though it is a fairly common condition. Raynaulds Disease is also referred to as Raynauld’s phenonmenon. Raynaud's is a condition in which cold temperatures or stress cause blood vessel spasms that block blood flow to fingers, toes, nose, and ears. This causes these body parts to suddenly turn ice cold and to become a purple or blue color. Later when the blood flow becomes normal the area turns a reddish color and later returns to normal. There are two types of Raynaud's Disease, primary Raynaud's disease and secondary Raynaud's disease. Primary Raynaud's is when a person has no other cause or condition. Secondary Raynaud's is when there is another condition that

If vasodilation were increased, that would increase the blood flow to the different body parts affected and would ultimately help the shortness of blood circulation around different areas of the body (Herrick 2005). Calcium channel blockers open up the blood vessels located on hands and feet. This decreases the amounts of attacks and relieves the symptoms. Some examples of calcium channel blockers are include nifedipine, amlodipine, and felodipine. Vasodilators are also prescribed in order to open up the blood vessels and increase blood flow. Nitroglycerin cream is usually applied to the base of the fingers to help and some medications, such as prostaglandins, may relieve the symptoms of Raynaud's phenomenon (Mayo Clinic 2016).

May’s pain became more noticeable and she became stiff, her body would ache and she was becoming slower in movement. It was diagnosed by her doctor with x- ray and blood results that May had rheumatoid arthritis. It has been treated with vitamin supplements, medication and oils/rubs to ease the pain. As the continuation of the case study proceeds May will be referred to as the client.