Exam (elaborations)
N450 PrepU CH 38 Rheumatic Disorders (1)
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N450 PrepU CH 38 Rheumatic Disorders (1)
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N450 PrepU CH 38 Rheumatic DisordersFibromyalgia is a common condition that involves - ANS-chronic fatigue, generalized muscle
aching, and stiffness
Fibromyalgia is a common condition that involves chronic fatigue, generalized muscle aching,
and stiffness. The cause is unknown, and no pathological characteristics specific for the
condition have been identified. Treatment consists of attention to the specific symptoms
reported by the client. NSAIDs may be used to treat the diffuse muscle aching and stiffness.
Tricyclic antidepressants are used to improve or restore normal sleep patterns, and
individualized programs of exercise are used to decrease muscle weakness and discomfort and
to improve the general deconditioning that occurs in these individuals.
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing
priority be? - ANS-Administering ordered analgesics and monitoring their effects
An acute exacerbation of rheumatoid arthritis can be very painful, and the nurse should make
pain management her priority. Client teaching, skin care, and supplying adaptive devices are
important, but these actions don't not take priority over pain management.
The nurse is reviewing the medication administration record of the client. Which medication
would lead the nurse to suspect that the client is suffering from an acute attack of gout? -
ANS-colchicine
Colchicine is prescribed for the treatment of an acute attack of gout.
A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give
the client about the medication? - ANS-Take the medication with food to avoid stomach upset
Ibuprofen is a non-steroidal anti-inflammatory drug. The nurse should advise the patient to take
NSAIDs with food to avoid stomach upset. Ibuprofen is available over the counter, but it still has
side effects. Aspirin is known to cause ringing in the ears, not NSAIDs.
The nurse is providing medication teaching to a client with rheumatoid disease. What common
actions are seen with diclofenac and aspirin? Select all that apply. - ANS-anti-inflammatory
analgesic
antipyretic
antiplatelet
Rheumatoid medications like aspirin and diclofenac actions are anti-inflammatory, analgesic,
antiplatelet, and antipyretic. Diclofenac has antispasmodic actions but aspirin does not.
, The nurse is teaching a client with osteoarthritis about the disease. What is the most important
client focus for disease management? - ANS-strategies for remaining active
The goals of osteoarthritis disease management are to decrease pain and stiffness and improve
joint mobility. Strategies for remaining active are the most important client focus. The detection
of complications, disease-modifying antirheumatic drugs management, and prevention of joint
deformity are considerations, but not the most important priorities for the client.
A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid
arthritis (RA). Which response is correct? - ANS-"OA is a noninflammatory joint disease. RA is
characterized by inflamed, swollen joints."
OA is a degenerative arthritis, characterized by the loss of cartilage on the articular surfaces of
weight-bearing joints with spur development. RA is characterized by inflammation of synovial
membranes and surrounding structures. OA may occur in one hip or knee and not the other,
whereas RA commonly affects the same joints bilaterally. RA is more common in women; OA
affects both sexes equally.
A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates
understanding of the disease process? - ANS-"It will get better and worse again."
The client demonstrates understanding of rheumatoid arthritis if he expresses that it's an
unpredictable disease characterized by periods of exacerbation and remission. There's no cure
for rheumatoid arthritis, but symptoms can be managed. Surgery may be indicated in some
cases.
Rheumatoid arthritis usually: - ANS-Involves smaller joints first (PIP & MCP).
RA targets the PIP, MCP and MTP joints first.
Scleroderma typically starts with which type of organ involvement? - ANS-Skin
Scleroderma commonly begins with skin involvement. Mononuclear cells cluster on the skin and
stimulate lymphokines to stimulate procollagen. Scleroderma does not commonly begin in the
lung, brain, or kidney.
The nurse is completing a health history with a client in a clinic. What assessment finding best
correlates with a diagnosis of osteoarthritis? - ANS-joint stiffness that increases with activity
A characteristic feature of osteoarthritis (degenerative joint disease) is joint stiffness that
increases with activity and movement. Erythema and edema over the affected joint, anorexia,
weight loss, and fever and malaise are associated with rheumatoid arthritis, a more severe and
destructive form of arthritis.
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