Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?

DHS 2018 shift 1st

Child Health Nursing (Pediatrics)

Medium

Appeared in: DHS 2018 shift 1st

Explanation

Swimming is a low-impact, non-weight-bearing exercise, making it ideal for individuals with arthritis.
The buoyancy of water supports the body's weight, which significantly reduces stress and pressure on inflamed joints.
It promotes a full range of motion, helping to maintain joint flexibility and prevent stiffness and contractures.
Swimming strengthens the muscles that support the joints, improving stability and function without causing further damage.

Option A: Playing video games is a sedentary activity that does not provide the necessary physical exercise to maintain joint mobility and muscle strength, which are critical for managing JRA.
Option C: Similar to video games, working crossword puzzles is a sedentary mental activity. It offers no physical benefits to counteract the effects of JRA, such as joint stiffness and muscle atrophy.
Option D: Slow-pitch softball is a high-impact sport that involves running, swinging, and sudden twisting movements. These actions can place significant stress on inflamed joints, leading to increased pain, swelling, and potential injury.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Selection of appropriate physical activity for a child with Juvenile Rheumatoid Arthritis (JRA) as background academic context rather than a clinical decision trigger.
A key nursing role in pediatric rheumatology is patient and family education about balancing rest and activity. Encouraging appropriate, low-impact exercise is fundamental to long-term joint health and mobility.
Nurses must assess the child's pain levels and disease activity to help tailor exercise recommendations. An activity plan should be flexible to accommodate for disease flare-ups and periods of remission.
What if the child is experiencing an acute flare-up of JRA? In that case, the priority shifts to rest and joint protection. Gentle range-of-motion exercises might be appropriate, but strenuous activities like swimming would be postponed until the acute inflammation subsides.

How to Approach the Question

First, identify the core clinical condition in the question: Juvenile Rheumatoid Arthritis (JRA).
Recall the pathophysiology of JRA: it is a chronic inflammatory disease of the joints. The goal of management is to reduce inflammation, preserve joint function, and maintain muscle strength.
Analyze the keywords 'best suited activity'. This implies you need to find an option that is beneficial and minimizes harm.
Evaluate each option based on its physical impact. Categorize them as sedentary, low-impact, or high-impact.
Eliminate the sedentary options (video games, crossword puzzles) as they do not promote physical function.
Compare the remaining physical activities. Softball is high-impact and risks joint injury. Swimming is low-impact and supports joints while allowing for exercise. Therefore, swimming is the most appropriate choice.

Concept Tested & Keywords

Concept Tested: Selection of appropriate physical activity for a child with Juvenile Rheumatoid Arthritis (JRA).
Stem keywords: 12-year-old, juvenile rheumatoid arthritis, activity
Lead-in keywords: best suited
Clinical cues: The patient's diagnosis of juvenile rheumatoid arthritis is the key factor, as it dictates the need for low-impact exercise to protect inflamed joints.

Q1phrHK_vVF92DU7_oyD2s

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 3 (pp 477-702 of 713) p. 8-10

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 653-655