Chapter 38: Assessment and Management of Patients With Rheumatic Disorders

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity? - "You have inherited your parent's immunity to the disease." - "Your symptoms are a result of your body attacking itself." - "You have antigens to the disease, but they do not prevent the disease." - "You are not immune to the disease causing the symptoms

"Your symptoms are a result of your body attacking itself." Explanation: In autoimmunity, the body mistakes its own tissue for foreign tissue and begins to attack it. Symptoms develop as the body destroys tissue. The body is in effect attacking itself. The other statements do not explain autoimmunity.

A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client? - Opioid therapy -Ice packs -Surgery - Nonsteroidal anti-inflammatory drugs

- Nonsteroidal anti-inflammatory drugs Explanation: Nonsteroidal anti-inflammatory drugs are the mainstay of treatment for rheumatoid arthritis pain. They help to decrease inflammation in the joints. Heat, rather than ice packs, is used to relieve pain. Paraffin baths may also help. Surgery is reserved for joint replacement when the joint is no longer functional; it is not an intervention specific to relieving pain. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 38: Assessment and Management of Patients With Rheumatic Disorders, p. 1095.

Which of the following is the most common cause for a patient to seek medical attention for arthritis? Pain Joint swelling Stiffness Weakness

Pain Explanation: The symptom that most commonly causes a person to seek medical attention is pain. Other common symptoms include joint swelling, limited movement, stiffness, weakness, and fatigue.

Which intervention should the nurse implement to manage pain for the client with rheumatoid arthritis? Select all that apply. -Support joints with splints and pillows. - Provide opportunities for the client to verbalize feelings. - Provide diversional activities. - Provide assistive devices for self-feeding. -Assist the client to develop a sleep routine.

Correct response: -Support joints with splints and pillows. - Provide diversional activities. - Provide opportunities for the client to verbalize feelings. To manage pain, the nurse maintains normal alignment of extremities as much as possible by supporting the joints with splints and pillows. Diversional activities distract the client's focus from the pain. Providing opportunities for the client to verbalize feelings facilitates coping with pain. Assistive devices for self-feeding help the client meet nutritional needs independently. Assisting the client to develop a sleep routine promotes rest and minimizes fatigue. Explanation: To manage pain, the nurse maintains normal alignment of extremities as much as possible by supporting the joints with splints and pillows. Diversional activities distract the client's focus from the pain. Providing opportunities for the client to verbalize feelings facilitates coping with pain. Assistive devices for self-feeding help the client meet nutritional needs independently. Assisting the client to develop a sleep routine promotes rest and minimizes fatigue.

A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client? -Opioid therapy - Ice packs -Surgery -Nonsteroidal anti-inflammatory drugs

Correct response: Nonsteroidal anti-inflammatory drugs Explanation: Nonsteroidal anti-inflammatory drugs are the mainstay of treatment for rheumatoid arthritis pain. They help to decrease inflammation in the joints. Heat, rather than ice packs, is used to relieve pain. Paraffin baths may also help. Surgery is reserved for joint replacement when the joint is no longer functional; it is not an intervention specific to relieving pain. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 38: Assessment and Management of Patients With Rheumatic Disorders, p. 1095.