Chapter 63: Caring for Clients with Orthopedic and Connective Tissue Disorders
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."
The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity?
"Your symptoms are a result of your body attacking itself."
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
A nurse is caring for an adult client diagnosed with back strain. Which health education will the nurse provide to this client to prevent future incidence of back injury? Select all that apply.
Avoid twisting the trunk of the body. Avoid lifting above waist level.
A nurse is teaching a client with osteomalacia about the role of diet. What would be the best choice for breakfast for a client with osteomalacia?
Cereal with milk, a scrambled egg, and grapefruit
The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms?
Chronic fatigue, generalized muscle aching, and stiffness
A client has rheumatoid arthritis and asks the nurse to explain how the illness progresses. Place in the correct sequence the pathophysiology of rheumatoid arthritis, from first to last step.
Congestion and edema develop in the synovial membrane and joint capsule. Synovial tissue experiences reactive hyperplasia. Vasodilation and increased blood flow cause warmth and redness, while increased capillary permeability causes swelling. Rheumatoid synovitis advances to pannus formation. Pannus destroys adjacent cartilage, joint capsule, and bone. Pannus forms between joint margins, reducing joint mobility and leading to potential ankylosis.
The nurse is educating a client with diabetes about prevention of infection. Which action does the nurse encourage to reduce the risk of osteomyelitis?
Control blood sugar levels.
Which group is at the greatest risk for osteoporosis?
European American women
A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA?
Joint stiffness, especially in the morning
An 80-year-old man in a long-term care facility has a chronic leg ulcer and states that the area has become increasingly painful in recent days. The nurse notes that the site is now swollen and warm to the touch. The client should undergo diagnostic testing for what health problem?
Osteomyelitis
A client with an acute exacerbation of arthritis is temporarily confined to bed. What position will the nurse recommend to prevent flexion deformities?
Prone
The nurse is educating the patient with low back pain about the proper way to lift objects. What muscle should the nurse encourage the patient to maximize?
Quadriceps
The health care team caring for a client has determined that their osteoporosis is caused by malabsorption. What is the usual treatment for osteoporosis caused by malabsorption?
Supplemental calcium and increased doses of vitamin D
The nurse teaches the client with a high risk for osteoporosis about risk-lowering strategies, including which action?
Walk or perform weight-bearing exercises outdoors
Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia
may feel as if their symptoms are not taken seriously.
A client's x-ray looks similar to the image depicted. The nurse would recognize that the client likely has a:
Hammer toe
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.
The nurse is caring for a client with palindromic rheumatism. The nurse knows that this type of rheumatism can lead to which diagnosis?
Rheumatoid arthritis
A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?
Take the medication with food to avoid stomach upset.
