Exam 2 Chapter 13.4 Osteoarthritis
The nurse is providing home care teaching to a client diagnosed with osteoarthritis. Which statement is appropriate for the nurse to include in the teaching session for this client? "Stretching all muscle groups for 30 minutes each day has been recommended by the healthcare provider." "When you begin your strengthening exercises, it is appropriate to start with a large weight and work your way down." "Water exercises should not be tried because water buoyancy increases force on the joints." "Balance and agility exercises can help maintain daily living skills and have been recommended by your healthcare provider."
"Balance and agility exercises can help maintain daily living skills and have been recommended by your healthcare provider."
The nurse is providing education to a community group about developing osteoarthritis. What joints, commonly affected, will the nurse include in the educational session? Ankles, feet, and spine Knees, feet, and spine Hands, knees, and hips Neck, shoulders, and ankles
Hands, knees, and hips
A nurse is providing a preventive teaching discussion with a client at risk for osteoarthritis. Which guideline should be included in this discussion related to exercise? If there is pain with exercise, keep going, this is building muscle Perform heavy weightlifting exercises three times per week Participate in regular exercise, including walking or swimming Exercise is not recommended
Participate in regular exercise, including walking or swimming
What are the common risk factors for osteoarthritis? (Select all that apply.) Autoimmune disorder Ingestion of large amounts of purine Activities affecting weight-bearing joints Obesity Overuse of joints from sports or strenuous activities
Activities affecting weight-bearing joints Obesity Overuse of joints from sports or strenuous activities
A client experiencing severe pain that cannot be managed through pain medications or nonpharmacologic therapy may need surgical intervention. Which surgical treatments will the nurse include in the teaching session with other members of the healthcare team? (Select all that apply.) Arthroplasty Joint fusion Serum hyaluronic acid Osteotomy Cortisone therapy
Arthroplasty Joint fusion Osteotomy
A client complains of knee pain during an appointment at a medical clinic. After reviewing the client's medical record, the nurse notes the client has been taking over-the-counter NSAIDs, with no pain relief. The nurse can anticipate the healthcare provider writing a prescription for what medication at discharge? Naproxen (Aleve) Morphine sulfate Acetaminophen (Tylenol) Celecoxib (Celebrex)
Celecoxib (Celebrex)
A client diagnosed with osteoarthritis of the hands presents with bony lumps on the end joints of her digits. How will the nurse document this finding in the medical record? Heberden nodes Bouchard nodes Osteoblasts Lymph node swelling
Heberden nodes
The nurse is planning care for a client with osteoarthritis. Which potential problem is priority for the nurse to address? (Select all that apply.) Impaired physical mobility Impaired skin integrity Chronic pain Fluid volume deficit Impaired cardiac output
Impaired physical mobility Chronic Pain
Which surgical treatment can be used to realign a joint that is affected by osteoarthritis? Arthroscopy Joint arthroplasty Osteotomy Joint biopsy
Osteotomy
The nurse is providing education at a community health fair about osteoarthritis. Which are the general clinical manifestations associated with osteoarthritis that the nurse should include when providing this education? (Select all that apply.) Mild fever Abrupt onset Pain and stiffness at night Crepitus with movement of joint Joint pain with activity
Pain and stiffness at night Crepitus with movement of joint Joint pain with activity
The nurse is providing education to a client who is scheduled for an osteotomy. Which information should the nurse include about this procedure? The procedure will stop osteoarthritis from progressing. Excess debris will be flushed out. The joint will be reconstructed. Realignment of the joint will occur.
Realignment of the joint will occur.
Jackie Waite, age 44, is diagnosed with osteoarthritis. Ms. Waite wants to know how this could have happened to her. Which rationale from Ms. Waite's health history supports this diagnosis? Repeated use of weight-bearing joints Childhood psoriasis Ingestion of purine-rich substances Chronic inflammation of peripheral joints
Repeated use of weight-bearing joints
Which diagnostic test will best determine the cause of joint damage with osteoarthritis? Joint x-ray MRI of joint Synovial fluid analysis Electromyogram (EMG)
Synovial fluid analysis
The nurse is providing education about home care for a client with osteoarthritis of the knees. Which information should the nurse include during this educational session? (Select all that apply.) Taking pain medications as ordered Installing handrails in bathroom Using assistive devices to minimize stress placed on affected joint Continuing activity with repetitive movement Encouraging heavy lifting to maintain muscle strength
Taking pain medications as ordered Installing handrails in bathroom Using assistive devices to minimize stress placed on affected joint
The nurse is planning care for a client with osteoarthritis of the hips. Which intervention will assist in addressing the potential problem of physical mobility? Recommend a local support group for the client and spouse. Educate the client about proper skin care. Encourage the client to avoid all physical activity. Teach active and passive range of motion exercises.
Teach active and passive range of motion exercises.
A client with possible osteoarthritis is scheduled for a synovial fluid analysis. The nurse should explain to the client that this diagnostic test is being completed for what reason? To rule out inflammatory arthritis and gout To determine the extent of joint damage To evaluate for increased density of subchondral bone To identify irregular joint space narrowing
To rule out inflammatory arthritis and gout
Which health promotion activities support a healthy lifestyle for clients with osteoarthritis? (Select all that apply.) Use soft chairs and recliners for rest Use assistive devices as needed Increase dietary intake of calcium Limit participation in ROM exercises Maintain a normal weight
Use assistive devices as needed Maintain a normal weight
Which interventions support effective management of chronic pain that is experienced by a client with osteoarthritis? (Select all that apply.) Using firm support in chairs and mattresses to properly align the body Encouraging resting painful joints Teaching proper posture and good body mechanics for activities of mobility Applying cool compresses to painful joints to reduce inflammation Limiting isometric exercises to reduce strain on the joints
Using firm support in chairs and mattresses to properly align the body Encouraging resting painful joints Teaching proper posture and good body mechanics for activities of mobility
Mrs. Gladek is a 70-year-old White woman who has experienced progressive symptoms of osteoarthritis over the past 5 years. In addition to taking prescribed analgesics and anti-inflammatory medications, she is discussing interventions that she implemented into her daily lifestyle to manage her disease condition. Which activity would you suggest to Mrs. Gladek to provide additional exercise opportunities for her? Interval training to jog a 5K Water aerobic activities Meditation Doubles tennis for older adults
Water aerobic activities
Mrs. Kingsley is a 64-year-old African American woman who has returned to the healthcare provider's office for follow-up of the osteoarthritic condition of her knees. Although both knees are affected, today her left knee is more swollen than the right knee. During your assessment, Mrs. Kingsley asks you, "If I am losing the cartilage in my knees, why do my knees look larger?" What would be an appropriate response? As your joint cartilage reduces, with exercise, muscle mass increases, which makes the knees look larger. With osteoarthritis, sometimes inflammation increases the size of your knees or fluid build-up occurs. Since your condition has progressed, your knees have developed contractures and this increases the size of the knees. Although the cartilage is destroyed, you may be building up more bone in the knee.
With osteoarthritis, sometimes inflammation increases the size of your knees or fluid build-up occurs.