PATHO CH 50

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Joint pain lasting for 30 minutes to several hours Decreased joint motion Nodules on joints

A nurse is assessing a client with rheumatoid arthritis (RA). What does the nurse expect to find when evaluating the client's joints? Select all that apply.

Systemic lupus erythematosus (SLE)

A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process?

Autoimmune process

A nurse is caring for a client who has systemic lupus erythematosis (SLE). Which of the following causes the disease?

"To prevent cartilage atrophy, slowly and gradually resume exercising."

A nurse is caring for a client with a fractured elbow. Which instruction is important to give the client to prevent cartilage degeneration while the elbow is immobilized?

"More women than men are affected by lupus."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?

"Genetic predisposition is very likely."

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology?

Weight and nutritional status

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?

Gonorrhea

Reiter syndrome is a reactive arthropathy. Reiter syndrome is associated with which disease?

Corticosteroids

Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. What is the treatment of choice for this myopathy?

"Extra-articular manifestations may include anemia and deformities of the affected joints."

A client recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" besides some joint swelling. Which information should the nurse tell the client about RA?

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

Kyphosis

A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?

Integumentary assessment

A nurse is caring for a client with discoid lupus. Which system does the nurse set as a priority for the nursing assessment?

Immunologically mediated joint inflammation

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

It's characterized by synovitis and can influence epiphyseal growth, resulting in stunted growth.

In general, how are children affected by a rheumatic disease such as juvenile idiopathic arthritis (JIA)?

"OA is a disease of the weight-bearing joints."

The nurse is caring for a client diagnosed with osteoarthritis (OA). What does the nurse teach the client about the disease?

NSAIDs

The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?

Physical examination and x-ray studies

The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate?

Raynaud's phenomenon.

The nurse assessing a client with scleroderma with CREST variant would include an assessment for:

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

The nurse determines that additional client education is needed when a client with gout makes which statement?

Tenderness Erythema Warmth Swelling

The nurse is assessing a client in early stage of rheumatoid arthritis. Which assessment findings would the nurse expect to find? Select all that apply.

Lower back pain

The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find?

Age

The nurse is assessing a client's risk for osteoarthritis. Which factor places the client at greatest risk for this condition?

Obesity is a strong risk factor for developing OA.

The nurse is conducting a health promotion class on osteoarthitis (OA). Which statement should the nurse include?

The injections will be given only 3 to 4 times per year because they can increase joint destruction.

The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?

Vascular granulation tissue that destroys cartilage and bone

The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus?

"Children can be affected with almost all of the rheumatic diseases that occur in adults."

The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:

Elevated anti-nuclear antibodies (ANA)

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?

Right knee is warm and painful when putting it through normal range of motion.

When assessing a child for clinical manifestations of oligoarticular arthritis, the health care provider will base the diagnosis on which clinical findings?

Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists.

When assessing a client with rheumatoid arthritis, which statement about joint involvement is mostaccurate?

Gentle exercise

When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention?

Risk for falls

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?

Client with systemic lupus erythematosus (SLE) and chest pain

Which clients with rheumatoid arthritis (RA) will the nurse prioritize to assess first?

Joint pain and proteinuria

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

Synovial fluid

Which substance helps maintain a smooth surface in joint cartilage?

Assessing the client's pain and history of treating it

A client presents with arthralgia and arthritis. Which is the priority nursing intervention?


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