"i saw on the news that overuse of hand sanitizer and anti-bacterial soap can result in kids having a weaker immune system and greater susceptibility to allergies. but the news is always reporting scare tactics to get people to act and my immune system is just fine. so, i don’t really care all that much." which stage is this?

Mrs. h, age 42 years, is experiencing severe rheumatoid arthritis in her wrists, fingers, and knees. the joints are quite inflamed, red, and swollen. she is sitting rigidly in a chair and refuses to put on a sweater, even though she is shivering, or let anyone touch her arms. she has been prescribed an analgesic and an anti-inflammatory drug, but her dose is not due for another hour. she is feeling nauseated, so she has not eaten for the past 8 hours. based on patient history and the signs and symptoms, discuss how the effects of pain are exacerbating her condition.