Chapter 34: Assessment and Management of Patients with Inflammatory Rheumatic Disorders - ML3

A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate?

Maintain good posture.

The nurse is planning teaching for a client with gout. Which topics will the nurse include in the teaching? Select all that apply.

Weight loss Decreasing alcohol intake Avoiding purine-rich foods

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?

pain

A client arrives at the orthopedic clinic and reports suspecting a stress fracture of the right foot. The physician orders an x-ray with negative results. What does the nurse understand that these negative results can mean?

purine-rich foods

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Administering ordered analgesics and monitoring their effects

An older adult with rheumatoid arthritis limits going out with others because of the need to use a cane. Which response will the nurse make to this client?

"Look at the cane as maintaining your independence."

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"My finger joints are oddly shaped."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate?

"The diagnosis won't be based on the findings of a single test but by combining all data found."

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?

Assess diet and activity at home

A client is experiencing painful joints and changes in the lungs, heart, and kidneys. For which condition will the nurse schedule this client for diagnostic tests?

Autoimmune disorders

Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?

Hypertension

A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not say when teaching the client and family information about managing the disease?

If you have problems with a medication, you may stop it until your next physician visit.

Which is the leading cause of disability and pain in the elderly?

Osteoarthritis (OA)

Primary gout is often caused by an inherited disorder in which type of metabolism?

Purine

Scleroderma typically starts with which type of organ involvement?

Skin

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?

Tophi

The nurse is caring for a client with ankylosing spondylitis. Which educational information will the nurse provide to this client?

Use of analgesics

Fibromyalgia is a common condition that involves

chronic fatigue, generalized muscle aching, and stiffness.

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?

colchicine

The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of

gout.

Osteoarthritis is known as a disease that

is the most common and frequently disabling of joint disorders.

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis?

joint stiffness that increases with activity

The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess?

low back pain

The nurse is working with a client with systemic lupus erythematosus (SLE). What are the immune abnormalities characterized by SLE? Select all that apply.

susceptibility abnormal innate and adaptive immune responses autoantibodies immune complexes inflammation damage

The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?

Celecoxib

The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms?

Chronic fatigue, generalized muscle aching, and stiffness

A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?

"Pace yourself and rest frequently, especially after activities."

A client with a discoid facial rash caused by systemic lupus erythematosus (SLE) asks why a urine sample is needed. Which response will the nurse make to the client?

"The lupus can affect your kidney function."

An older adult with rheumatoid arthritis says exercise was not effective. Which response will the nurse make to learn the reason for the failure of this treatment approach?

"What types of exercise were you doing?"

As part of the assessment process for a client suspected of having gout, the nurse evaluated the client's serum uric acid levels. Select the value that is considered above the saturation point for crystal formation.

6.8 mg/dL (0.40 mmol/L)