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Chapter 64: Arthritis and Connective Tissue Diseases ANS
Terms in this set (46)
Which finding will the nurse expect when assessing a 58-year-old patient who has osteoarthritis (OA) of the knee?
Discomfort with joint movement
Which assessment finding about a patient who has been using naproxen (Naprosyn) for 6 weeks to treat osteoarthritis is most important for the nurse to report to the health care provider?
The patient has dark-colored stools.
After the nurse has finished teaching a 68-year-old patient with osteoarthritis (OA) of the right hip about how to manage the OA, which patient statement indicates a need for more teaching?
"I will take 1 g of acetaminophen (Tylenol) every 4 hours."
The nurse will anticipate the need to teach a 57-year-old patient who has osteoarthritis (OA) about which medication?
Capsaicin cream (Zostrix)
A patient with rheumatoid arthritis being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?
Assess the nodules for skin breakdown or infection.
Which action will the nurse include in the plan of care for a 33-year-old patient with a new diagnosis of rheumatoid arthritis?
Suggest that the patient take a nap in the afternoon.
A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is most appropriate?
Suggest that the patient use over-the-counter (OTC) artificial tears.
Which information will the nurse include when preparing teaching materials for patients with exacerbations of rheumatoid arthritis?
Application of cold packs before exercise may decrease joint pain.
Which laboratory result will the nurse monitor to determine whether prednisone (Deltasone) has been effective for a 30-year-old patient with an acute exacerbation of rheumatoid arthritis?
C-reactive protein level
The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests that they
avoid activities that require repetitive use of the same muscles and joints.
The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with
a warm bath followed by a short rest.
Anakinra (Kineret) is prescribed for a 49-year-old patient who has rheumatoid arthritis (RA). When teaching the patient about this drug, the nurse will include information about
self-administration of subcutaneous injections.
A 37-year-old patient with 2 school-age children who has recently been diagnosed with rheumatoid arthritis (RA) tells the nurse that home life is very stressful. Which response by the nurse is most appropriate?
"Tell me more about situations that are causing you stress."
Which information will the nurse include when teaching a 38-year-old male patient with newly diagnosed ankylosing spondylitis (AS) about the management of the condition?
Do daily deep-breathing exercises.
A 19-year-old patient hospitalized with a fever and red, hot, and painful knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient
is sexually active with multiple partners.
The nurse notices a circular lesion with a red border and clear center on the arm of an 18-year-old summer camp counselor who is in the camp clinic complaining of chills and muscle aches. Which action should the nurse take next?
Ask the patient about recent outdoor activities.
A 29-year-old patient reporting painful urination and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with
The nurse determines that colchicine has been effective for a patient with an acute attack of gout upon finding
relief of joint pain.
A patient with gout has a new prescription for losartan (Cozaar) to control the condition. The nurse will plan to monitor
A 71-year-old patient who takes multiple medications develops acute gouty arthritis. The nurse will consult with the health care provider before giving the prescribed dose of
Which statement by a patient with systemic lupus erythematosus (SLE) indicates that the patient has understood the nurse's teaching about the condition?
"I will use sunscreen when I am outside."
A 25-year-old female patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, "I never leave my house because I hate the way I look." An appropriate nursing diagnosis for the patient is
social isolation related to embarrassment about the effects of SLE.
A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review?
Anti-Smith antibody (Anti-Sm)
The nurse is planning care for a patient with hypertension and gout who has a red and painful right great toe. Which nursing action will be included in the plan of care?
Use a footboard to hold bedding away from the toe.
The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question?
Administer varicella vaccine.
A 40-year-old African American patient has scleroderma manifested by CREST (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) syndrome. Which action will the nurse include in the plan of care?
Keep environment warm and draft free.
The nurse determines that additional instruction is needed when a patient diagnosed with scleroderma says which of the following?
"I should lie down for an hour after each meal."
When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate (Rheumatrex). The patient tells the nurse, "My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is
"It is important to start methotrexate early to decrease the extent of joint damage."
Which assessment information obtained by the nurse indicates that a patient with an exacerbation of rheumatoid arthritis (RA) is experiencing a side effect of prednisone (Deltasone)?
The patient's blood glucose is 165 mg/dL.
The home health nurse is doing a follow-up visit to a 41-year-old patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates that more patient teaching is needed?
The patient sleeps with two pillows under the head.
A patient with an acute attack of gout in the right great toe has a new prescription for probenecid (Benemid). Which information about the patient's home routine indicates a need for teaching regarding gout management?
The patient takes one aspirin a day to prevent angina.
Which result for a 30-year-old patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider?
Elevated blood urea nitrogen (BUN)
Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis is likely to be an adverse effect of the medication?
A 31-year-old woman is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider about the methotrexate?
The patient is trying to get pregnant before her disease becomes more severe.
Which laboratory data is important to communicate to the health care provider for a patient who is taking methotrexate (Rheumatrex) to treat rheumatoid arthritis?
The white blood cell (WBC) count is 1500/µL.
A patient who had arthroscopic surgery of the right knee 7 days ago is admitted with a red, swollen, and hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately?
The blood pressure is 86/50 mm Hg.
A 63-year-old patient hospitalized with polymyositis has joint pain, an erythematosus facial rash, eyelid edema, and a weak, hoarse voice. The priority nursing diagnosis for the patient is
risk for aspiration related to dysphagia.
A 46-year-old male patient with dermatomyositis is receiving long-term prednisone (Deltasone) therapy. Which assessment finding by the nurse is most important to report to the health care provider?
The patient has painful hematuria.
Which patient seen by the nurse in the outpatient clinic is most likely to require teaching about ways to reduce risk for osteoarthritis (OA)?
A 56-year-old woman who works on an automotive assembly line
Which action will the nurse include in the plan of care for a 40-year-old with newly diagnosed ankylosing spondylitis?
Advise the patient to sleep on the back with a flat pillow.
After the nurse has taught a 28-year-old with fibromyalgia, which statement by the patient indicates a good understanding of effective self-management?
"I will need to stop drinking so much coffee and soda."
Which information will the nurse include when teaching a patient with newly diagnosed chronic fatigue syndrome about self-management?
A gradual increase in your daily exercise may help decrease fatigue.
After the nurse assesses a 78-year-old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management, which information is most important to report to the health care provider?
Laboratory results indicate blood urea nitrogen (BUN) is elevated.
A 28-year-old with psoriatic arthritis and back pain is receiving etanercept (Enbrel). Which finding is most important for the nurse to report to the health care provider?
Crackles are heard in both lung bases.
Which nursing action can the registered nurse (RN) delegate to unlicensed assistive personnel (UAP) who are assisting with the care of a patient with scleroderma?
Document the patient's oral intake.
During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the following (select all that apply)?
* Sleep disturbances
* Multiple tender points
*Widespread bilateral, burning musculoskeletal pain
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