The nurse assesses a client with long-term rheumatoid arthritis (RA) for late signs and symptoms. Which assessment findings will the nurse document as late signs and symptoms of RA? (Select all that apply)

Choice A reason: Anorexia is not a hallmark late sign of RA. It may occur early due to systemic inflammation but is less specific in late stages, where joint damage and systemic complications like Felty syndrome dominate.
Choice B reason: Felty syndrome, a late RA complication, involves neutropenia, splenomegaly, and recurrent infections due to chronic immune activation. It occurs in long-standing RA, reflecting severe disease progression, making it a key late finding.
Choice C reason: Joint deformity (e.g., swan-neck, boutonniere) is a classic late RA sign due to chronic synovial inflammation eroding cartilage and bone, causing joint instability and deformation, significantly impacting function in advanced disease.
Choice D reason: Low-grade fever is an early RA symptom due to systemic inflammation but typically diminishes in late stages. Chronic joint damage and systemic complications are more prominent, making fever less characteristic of late RA.
Choice E reason: Weight loss is a late RA sign due to chronic inflammation, increased metabolic demand, and cytokine activity (e.g., TNF-alpha). It reflects disease severity and systemic impact, common in advanced RA with joint destruction.