ARTHRITIS AND CONNECTIVE TISSUE DISEASES

During assessment of the patient with fibromyalgia, the nurse should expect the patient to report which of the following

SLEEP DISTURBANCES. MULTIPEL TENDER POINTS. WIDESPREAD BILATERAL, BURNING MUSCULARSKELETAL PAIN

Which patient seen by the nurse in the outpatient clinic is MOST likely to need teaching about ways to reduce the risk for osteoarthritis (OA)?

a 56 year old woman who works on an automotive assembly line

Which information should the nurse include when teaching a patient with newly diagnosed systemic exertion intolerance disease (SEID) about self management?

a gradual increase in daily exercise may help decrease fatigue

How should the nurse suggest that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day

a warm bath followed by a short rest

What suggestions should the nurse make to a group of women with rheumatoid arthritis (RA) about managing activities of daily living?

avoid activities requiring repetitive use of the same muscles or joints

When reviewing the health record for a new patient with rheumatoid arthritis, the nurse reads that the patient has swan neck deformities. Which deformity should the nurse expect to observe when assessing the patient

fingers are bent hyper flexion and hyperextension

Anakinra (Kineret) is prescribed for a patient with rheumatoid arthritis (RA). What information should the nurse include in teaching the patient about this drug?

giving subcutaneous injections

What action should the nurse include in the plan of care for a patient with newly diagnosed ankylosing spondylitis

have the patient sleep on their back with a flat pillow

A patient who takes multiple medications develops acute gout arthritis. Which medication should the nurse discuss with the health care provider before administering a prescribed dose?

hydrochlorothiazide

When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse "my arthritis isn't that bad yet. The side effects are worse than the arthritis". What is the MOST appropriate response by the nurse?

it is important to start methotrexate early to decrease the extent of joint damage

A patient has scleroderma manifested by CREST syndrome. Which action should the nurse include in the plan of care?

keep the environment warm and draft free

The nurse assesses a 78 yr old who uses naproxen (aleve) daily for hand and knee osteoarthritis management. Which information should the nurse discuss with the health care provider for an urgent change in treatment plans?

lab results indicate BUN is elevated

What finding should indicate to the nurse that colchicine has been effective for a patient with an acute attack of gout?

reduced joint pain

A patient hospitalized with polymyositis has joint pain; erythematous facial rash, eyelid edema, a week and hoarse voice. What safety priority should the nurse identify for this patient

risk for aspiriation

what information from a patient's health history should the nurse identify as a risk factor for septic arthritis

sexually active with several partners

A 25 yr old female patient with systemic lupus erythematosus (SLE) has a facial rash and alopecia. She tells the nurse "I never leave my house because I hate the way I look". Which patient problem should the nurse plan to address?

social isolation

A patient with rheumatoid arthritis (RA) tells the clinic nurse about having chronically dry eyes. What action should the nurse take?

suggest the patient use over the counter artificial tears

A patient has recently been diagnosed with rheumatoid arthritis (RA). The patient, who has two school aged children, tells the nurse that home life is very stressful. Which INITIAL response should the nurse make

tell me more about the situations that are causing you stress

A patient who has arthroscopic surgery of the right knee 7 days ago is admitted with a red swollen hot knee. Which assessment finding should the nurse report immediately to the health care provider

the blood pressure is 86/50

The nurse is assessing a patient with osteoarthritis who uses naproxen (Naproxyn) for pain management. Which assessment finding should the nurse recognize as likely to require a change in medication

the patient has dark colored stools

A patient with dermatomyositis is receiving long term prednisone therapy. Which assessment finding should the nurse report immediately to the health care provider?

the patient has painful hematuria

A 29 yr old woman is taking methotrexate to treat rheumatoid arthritis. Considering this treatment, which information should the nurse report to the health care provider?

the patient is trying to get pregnant before her disease becomes more severe

The home health nurse is making a follow up visit to a patient recently diagnosed with rheumatoid arthritis (RA).Which finding indicates to the nurse that additional patient teaching is needed

the patient sleeps with two pillows under the head

A patient with an acute attack of gout in the right big toe has a new prescription for probenecid. Whwat information about the patients home routine should the nurse understand indictes a need for teaching regarding gout management?

the patient takes one aspirin a day to prevent angina

What assessment information should indicate to the nurse that a patient with an exacerbation of rheumatoid arthritis (RA) is experiencing a side effect of prednisone?

the patients blood glucose is 165

a patient is taking methotrexate to treat rheumatoid arthritis (RA). Which lab result is important for the nurse to communicate to the health care provider

the white blood cell count is 1500

A patient with hypertension and gout has a red, painful right toe. Which action should the nurse include in the plan of care for this patient

use the footboard to hold the bedding away from the toe

a patient with gout has a new prescription for losartan (Cozaar). What should the nurse plan to monitor?

blood pressure

Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat rheumatoid arthritis should the nurse identify as a likely adverse effect on the medication

blurred vision

A patient 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 auscultated in the lung bases

Which statement by a patient with systemic lupus erythematosus (SLE) indicates the patient understands the nurse's teaching about the condition?

I will use sunscreen when I'm outside

Which lab result should the nurse monitor to determine if prednisone has been effective for a patient who has an acute exacerbation of rheumatoid arthritis?

C-reactive protein

The nurse should determine additional instruction is needed when a patient diagnosed with scleroderma makes which statement

I should lie down for an hour after each meal

After teaching a 28 year old with fibromyalgia about the disease, which patient statement does the nurse determine indicates a good understanding of effective self-management?

I will need to stop drinking so much coffee and soda

The nurse teaches a patient with osteoarthritis (OA) of the hip and how to manage of OA. Which patient statement indicates to the nurse a need for additional teaching?

I will take 1 gram of acetaminophen every 4 hours

The health care provider has prescribed the following interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus (SLE). Which order should the nurse question?

administer varicella vaccine

A new clinic patient with joint swelling and pain is having diagnostic tests. Which test should the nurse identify as SPECIFIC to systemic lupus erythematosus (SLE

anti smith antibody (anti-SM)

Which information should the nurse include when preparing teaching materials for a patient who has an exacerbation of rheumatoid arthritis?

applying cold packs before exercise may decrease joint pain

The nurse notices a circular lesion with a red border and clear center on the arm of a patient who is in the clinic reporting chills and muscle aches. Which action should the nurse take to follow up on that finding

ask the patient about recent outdoor activities

A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action should the nurse take

assess the nodules for skin breakdown or infection

The nurse should anticipate the need to teach a patient who has osteoarthritis (OA) about which medicine

capsaicin cream (Zostrix)

Which finding should the nurse expect when assessing a patient who has osteoarthritis (OA) of the knee

discomfort with joint movement

Which information should the nurse include when teaching a patient with newly diagnosed ankylosing spondylitis (AS) about managing the condition

do daily deep breathing exercises

Which action for the care of a patient who has scleroderma can the RN delegate to unlicensed assistive personnel

document the patients oral intake

A patient reporting painful urination and knee pain is diagnosed with reactive arthritis. What long -term therapy should the nurse plan to explain to the patient

doxycycline

Which result for a patient with systemic lupus erythematosus (SLE) should the nurse identify as MOST important to communicate to the health care provider?

elevated BUN

Which action should the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA)?

encourage the patient to take a nap in the afternoons