Chapter 36

The client asks the nurse about types of exercise that do not stress the joints. What exercise will the nurse include in the teaching plan?

T'ai chi is low impact, so this is the best exercise for low joint impact

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

Use the large muscles of the leg when lifting items.

The nurse is assisting a client with removing shoes prior to an examination and observes that the client has a flexion deformity of several toes on both feet of the proximal interphalangeal (PIP) joints. What can the nurse encourage the client to do?

Wear properly fitting shoes.

Mallet toe

flexion deformity of the distal interphalangeal joint (DIP),

The nurse is assessing a client with decreased dexterity of the hands related to rheumatoid arthritis. The nurse knows that which process causes joint deformities?

Inflammation

he nurse is collaborating with the health care provider on a plan of care for a 54-year-old male client with osteomyelitis of the left femur secondary to uncontrolled type 1 diabetes.

Perform neurovascular checks of lower extremities every 8 hrs Administer IV antibiotic based on culture and sensitivity report. Administer ibuprofen 400 mg orally three times daily, as needed for pain. Make referral to dietitian to discuss nutrition for healing and blood glucose control.Provide education on self-blood glucose monitoring and insulin administration.

A client has Paget's disease. An appropriate nursing diagnosis for this client is:

Risk for falls

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.

Management between the attacks of gout include lifestyle changes to include weight loss, decreasing alcohol intake, and avoiding purine-rich foods

A nurse is performing discharge teaching for an elderly client with osteoporosis. Which instruction about a calcium supplement should the nurse include?

Take the supplement with meals or with orange juice.

Health education for a woman over age 50 includes providing information about the importance of adequate amounts of calcium and vitamin D to prevent osteoporosis. Select the daily dosage of calcium and vitamin D that the nurse should recommend.

The daily recommended dosage is 1,200 mg of calcium and 1,000 IU of vitamin D.

The nurse is caring for a client with scleroderma. Which findings will the nurse expect during the physical assessment? Select all that apply.

The skin and subcutaneous tissues become increasingly hard and rigid due to excess collagen and cannot be pinched up from the underlying structures. The skin is dry because sweat secretion over the involved region is suppressed. The extremities stiffen and lose mobility. The face appears masklike, immobile, and expressionless. Wrinkles and lines are obliterated.

Hallux valgus,

bunion, is a deformity of the great (large) toe at its metatarsophalangeal joint.

A client with rheumatoid arthritis tells the nurse about experiencing mild tinnitus, gastric intolerance, and rectal bleeding. What medication does the nurse suspect is causing these side effects?

aspirin

A nurse is assessing a client with possible osteoarthritis. What is the most significant risk factor for primary osteoarthritis?

Age is the most significant risk factor for developing primary osteoarthritis

A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain?

An exercise routine that includes range-of-motion (ROM) exercises

A client with rheumatoid arthritis wants to participate in water aerobics classes for arthritis at the community center. Which statement will the nurse respond to this client?

Be sure to wear nonslip footwear for safety."

An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density? You Selected:

Compression fractures

Dupuytren contracture causes flexion of which area(s)?

Fourth and fifth fingers

During a routine physical examination of a client, the nurse observes a flexion deformity of the proximal interphalangeal (PIP) joint of two toes on the right foot. How would the nurse document this finding?

Hammer toe

A client who has been diagnosed with osteoarthritis asks if he or she will eventually begin to notice deformities in the hands and fingers as the condition progresses. Which concept should the nurse include in the response?

Hand and finger deformities are associated with the development of rheumatoid arthritis.

The nurse is teaching a client about the characteristics of osteoarthritis. The nurse determines the client teaching was successful when the client states that which of the following may occur with osteoarthritis?

Heberden nodes are a characteristic finding of osteoarthritis.