Nur 242 exam 6
The nurse is counseling an HIV positive woman on precautions to be followed. Which statement by the client indicates the need for further counseling?
"I will go for pelvic examination every 12 months." ( q 6 month)
Which statement by the client who has multiple sclerosis indicates a need for further teaching?
"I will take a hot bath to help relax my muscles.
Which clinical manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. One, some, or all responses may be correct
- pericarditis - discoid lesions - pleural effusions . SLE is a chronic, progressive inflammatory connective tissue disorder that can cause major organs and systems to fail. Pericarditis is a cardiovascular manifestation of SLE. Discoid lesion is a skin manifestation that is a key indicator of the presence of SLE. Pleural effusion, a pulmonary manifestation, is a key indicator of the presence of SLE. Esophagitis is one of the gastrointestinal manifestations of systemic sclerosis. Fibrotic skin is one of the skin manifestations of systemic sclerosis.
Which intervention would the nurse teach the client who has rheumatoid arthritis to alternate with periods of rest?
Active exercises
Which act protects a person who is HIV positive?
Americans with Disabilities Act (ADA)
The nurse is making room assignments on the pediatric unit. Who is the best choice of roommate for a 10-year-old boy with juvenile idiopathic arthritis?
An 11-year-old boy who has undergone splenectomy
Which laboratory test would the nurse review for a client suspected to have rheumatoid arthritis?
Antinuclear antibody
Which cytokine would the nurse teach a client is treatment for multiple sclerosis?
B-interferon
Which immunomodulatory agent is beneficial for the treatment of clients with multiple sclerosis?
Beta interferon
When developing the plan of care for a client with rheumatoid arthritis, which client consideration would the nurse include?
Comfort
Which is most important for the nurse to attempt to prevent for a child with juvenile idiopathic arthritis (JIA)?
Contracture deformitie
An ambulatory client with relapsing-remitting multiple sclerosis is to receive every-other-day injections of interferon beta-1a. Which adverse effects would the nurse explain may occur when taking this medication? Select all that apply. One, some, or all responses may be correct.
Depression, flu-like symptoms, increased risk for infection
The nurse is coordinating care for a client with severe rheumatoid arthritis. Which health team perspective for planning care would promote the client's self-reliance and independence?
Developing a positive attitude toward the eventual outcome
Which clinical findings would the nurse anticipate for a client who has an exacerbation of multiple sclerosis? Select all that apply. One, some, or all responses may be correct.
Double vision (diploxia), scanning speech
The nurse is obtaining a health history from a client with human immunodeficiency virus (HIV) with a low viral load who has been asymptomatic for years. Which statement by the client indicates the need for additional education on the disease process?
I occasionally have oral sex without the use of protection."
A client with an acute exacerbation of rheumatoid arthritis is in severe pain and tells the nurse, "The only time I am pain free is when I lie perfectly still." Which complication would the nurse explain that could be prevented by daily exercise?
Shortening of the muscles (Flexion and extension prevent tightening of muscles and tendons. Abnormal sensations (paresthesias) are related to neurological, not musculoskeletal, alterations. Weight bearing, not exercise, promotes the development of osteoblasts. Loss of muscular coordination is the result of cerebellar changes; it is not related to immobility)
A client who has multiple sclerosis asks the nurse, "Will I experience unbearable pain?" Which response would the nurse make?
Some clients report tingling or burning but not unbearable pain."
A recently hospitalized client with multiple sclerosis voices a concern about generalized weakness and fluctuating physical status. Which nursing intervention is the priority for this client?
Space activities throughout the day
Which potential clinical manifestations would the nurse associate with a client diagnosed with systemic lupus erythematosus (SLE)? Select all that apply. One, some, or all responses may be correct.
Joint pain, facial rash, pericarditis, weight gain . SLE is a chronic autoimmune disease that affects connective tissue; joint pain is common. A butterfly rash on the face is characteristic of SLE. Pericarditis is the most common cardiac indicator of SLE. Weight loss, not gain, is a classic sign of SLE because of gastrointestinal effects. Renal impairment with SLE may cause hypertension, not hypotension.
A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce the frequency of exacerbations, what would be important for the nurse to include in the client's teaching plan?
Techniques to reduce stress
A client with systemic lupus erythematosus (SLE) is at 39 weeks' gestation. Which would the nurse anticipate regarding this client?
A need to discontinue the client's salicylate therapy
Aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis. The nurse understands that the medication is being used primarily for which property?
Anti-inflammatory
Which intervention would relieve the discomfort of knee pain for the child with juvenile idiopathic arthritis (JIA)?
Application of moist heat
A nurse is creating a plan of care for a client with rheumatoid arthritis who has severe pain and swelling of the hand joints. Which details about range-of-motion exercises would the plan include?
Applying heat or cold before the exercises
Which medication would the nurse anticipate the health care provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis?
Aspirin
Which action by a client taking immunosuppressant medication for rheumatoid arthritis indicates to the nurse the need for additional teaching?
Attends crowded sporting events
hospitalized client newly diagnosed with rheumatoid arthritis complains of bilaterally painful knee and wrist joints. The nurse identifies impaired physical mobility related to painful, swollen joints. Which intervention would the nurse teach the client to do during the acute phase of the disease
Avoid movement of the involved joints
Aspirin is prescribed for a client with rheumatoid arthritis. Which clinical indicators of aspirin toxicity will the nurse teach the client to report? Select all that apply. One, some, or all responses may be correct.
Blood in stool, ringing in ears (Blood in the stool indicates gastrointestinal irritation and may have resulted from the anticoagulant effect of aspirin. Salicylates, such as aspirin, can cause ototoxicity (affects eighth cranial nerve), which may manifest as ringing in the ears (tinnitus) or muffled hearing and it should be reported. Joint pain is not a symptom of salicylate toxicity; however, it is related to the disease process and should be minimized by the administration of aspirin. Bradycardia and increased urine output (polyuria) do not indicate salicylate toxicity)
A child with juvenile idiopathic arthritis is prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs would the nurse include in discharge instructions to the child and family?
Blood in the urine. Hematuria may result from the use of NSAIDs because they may cause nephrotoxicity. Diarrhea can occur but is not a sign of toxicity. Hypothermia does not occur with NSAIDs. Drowsiness, not hyperactivity, may occur.
A client with systemic lupus erythematosus is taking prednisone. Which foods would the nurse encourage the client to eat while receiving treatment to prevent hypokalemia?
Broccoli. Potassium is plentiful in green leafy vegetables; broccoli provides 207 mg of potassium per half cup. Oatmeal provides 73 mg of potassium per half cup. Rice provides 29 mg of potassium per half cup. Cooked fresh carrots provide 172 mg of potassium per half cup; canned carrots provide only 93 mg of potassium per half cup.
A client who has rheumatoid arthritis reports that pain with exercising has increased. Which suggestion would the nurse provide to the client to decrease pain? I'm
Decrease the number of repetitions of the exercises (Exercise should be performed to tolerance only; limiting the amount of exercise should decrease pain. To relax the joints, the client should take a hot shower versus a tub bath. Furthermore, it will be difficult for a client with stiff joints to get into a typical bathtub. Ice should never be placed against the skin without a layer of protection; further damage or frostbite could occur. Ceasing exercise for a day will increase stiffness)
A client with severe chronic rheumatoid arthritis reports that pain lasts for 2 to 3 hours after exercising. Which information would the nurse teach the client?
Decrease the time and number of exercise repetitions
Which assessment findings would the nurse identify in a client with clinical manifestations of rheumatoid arthritis (RA)? Select all that apply. One, some, or all responses may be correct.
Development of antinuclear antibodies Inflammatory disease pattern Bilateral involvement of metacarpophalangeal joints
Which organ is commonly affected in children with juvenile idiopathic arthritis (JIA)?
Eyes
Several minutes after the start of a red blood cell infusion, the client reports itching. The nurse observes hives on the client's chest. Which action would the nurse take?
Stop the transfusion
A client taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted. Which response by the nurse is appropriate?
buprofen has anti-inflammatory properties, and acetaminophen does not."( buprofen has an anti-inflammatory action that relieves the inflammation and pain associated with arthritis. Ibuprofen is not an antipyretic. Acetaminophen does not cause gastritis; this is an effect of aspirin. Acetaminophen is not a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are preferred for the treatment of rheumatoid arthritis)
While conducting an assessment, the nurse finds that the client shivers uncontrollably and experiences memory loss, depression, and poor judgment. Which might the client's body temperature be?
33 C .A body temperature in the range of 36°C to 38°C is normal. When skin temperature drops below 35°C, the client may exhibit uncontrolled shivering, loss of memory, depression, and poor judgment as a result of hypothermia. A body temperature lower than 30°C represents severe hypothermia. In this condition, the client will demonstrate a lack of response to stimuli and extremely slow respiration and pulse. Based on the signs given, the client's temperature is most likely 33°C.
Which finding would the nurse expect to identify in a client who has osteoarthritis that would not be present in clients with rheumatoid arthritis?
Heberden nodes (Heberden nodules are the bony or cartilaginous enlargements of the distal interphalangeal joints that are associated with osteoarthritis. Ulnar drift, swan-neck deformity, and boutonnière deformity occur with rheumatoid arthritis)
Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has swollen finger joints?
Inflammation in the joint's synovial lining
On reviewing the x-ray report of a client with rheumatoid arthritis, the nurse learns that three small joints are involved. Which score will the nurse assign the client for joint involvement?
2. According to the diagnostic criteria for rheumatoid arthritis, involvement of one to three small joints (with or without large-joint involvement) is given a score of 2. Involvement of two to 10 large joints is given a score of 1. Involvement of four to 10 small joints (with or without large-joint involvement) is given a score of 3. Involvement of more than 10 joints (and at least one small joint) is given a score of 5.
Which precaution would the nurse identify as a prevention for transmission of human immunodeficiency virus (HIV) and other bloodborne illnesses?
standard
When would the nurse expect the client who has rheumatoid arthritis to experience the most joint pain and stiffness?
In the morning on awakening
An HIV-infected pregnant adolescent does not want a cesarean birth. Which finding would indicate the increased risk of perinatal transmission via vaginal birth?
A viral load of 1,200 copies/mL
Which dietary changes would the nurse suggest to the client with diarrhea associated with human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct.
Eat much less roughage, Drink plenty of fluids between meals."
An adolescent has been admitted with a history of symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematosus. Which is the best intervention at this time?
Education about diet, rest, and exercise
After a painful exacerbation of rheumatoid arthritis, a client is scheduled to begin a walking and exercise program. Which statements describes an expected outcome for this client?
Exercise and be active unless the discomfort becomes too great.
Which education would the nurse provide the family of an infant who is human immunodeficiency virus (HIV) positive about the best long-term care environment?
Home environment
client who has been diagnosed with human immunodeficiency virus (HIV) tells the nurse, "I have taken this as a challenge, and I will be able to fight this tough battle." This is an example of which concept of spiritual health?
Hope
Which statement indicates a client understands transmission of the human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct.
I can contract HIV by participating in oral sex.", HIV is contracted by using contaminated needles, Babies can contract HIV because of contact with maternal blood during birth
The nurse is providing discharge teaching to a client who was hospitalized for exacerbation of rheumatoid arthritis. Which statement by the client indicates correct understanding of the treatment plan?
I will reduce the number of exercise repetitions when I have pain.
Which medications inhibit tumor necrosis factor-alpha (TNF)-a in clients treated for rheumatoid arthritis (RA)? Select all that apply. One, some, or all responses may be correct.
Infliximab, Etanercept, Golimumab (Biologic response modifiers (BRMs) are the substances that modify immune responses by either enhancing an immune response or suppressing it. Infliximab, etanercept, and golimumab are BRMs used in the treatment of RA to inhibit tumor necrosis factor (TNF)-a. Anakinra is an interleukin-1 receptor antagonist used in the treatment of RA. Abatacept is a selective T-lymphocyte costimulator modulator (T-cell inhibitor) used in the treatment of RA)
Which educational topic is a high priority for the nurse providing education to a client with systemic lupus erythematosus?
Instructing about ways to protect the skin
The nurse assesses a client with severe nodule-forming rheumatoid arthritis for possible Felty syndrome. Which assessment findings are consistent with Felty syndrome? Select all that apply. One, some, or all responses may be correct.
Leukopenia, splenomegaly (Felty syndrome occurs most commonly in clients with severe nodule-forming rheumatoid arthritis; and characterized by splenomegaly and leukopenia. Itchy eyes, dry mouth, and photosensitivity are all signs of Sjögren syndrome)
Which findings would the nurse expect when assessing a client who is in an early stage of multiple sclerosis? Select all that apply. One, some, or all responses may be correct.
Nystagmus, scanning speech, intentional tremors
A client asks the nurse what causes the sudden loss of vision common in persons with multiple sclerosis. Which factor would the nurse include in the explanation?
Optic nerve inflammation
Which outcome is likely if direct pressure is applied to the joints of a client who has an acute episode of rheumatoid arthritis?
Pain
A client newly diagnosed with multiple sclerosis asks the nurse, "Will I experience pain?" Which response would the nurse give?
Pain is not a characteristic symptom of this condition."
The parents of a child with juvenile idiopathic arthritis are investigating other therapies to use with medications. Which therapy would the nurse recommend?
Physical therapy
An older client is admitted to a nursing home. The client is incontinent of urine. The client's rheumatoid arthritis contributes to severely painful joints. Which client need would the nurse identify as the primary consideration in the care of this client?
Relief of pain
The nurse teaches a client with multiple sclerosis methods to reduce fatigue. Which statement indicates an understanding of the education?
Rest in an air-conditioned room
Which suggestion would the nurse make to a client with rheumatoid arthritis who asks about ways to decrease morning stiffness?
Take a hot bath or shower in the morning. (Moist heat increases circulation and decreases muscle tension, which help relieve chronic stiffness. Although wearing loose but warm clothing is advisable for someone with arthritis, it does not relieve morning stiffness. Inactivity promotes stiffness. The practice of avoiding excessive physical stress and fatigue is related to muscle fatigue, not to stiffness of joints)
A client who is newly diagnosed with multiple sclerosis is obviously upset and asks, "Am I going to die?" Which response would the nurse make?
The prognosis varies, as most individuals have remissions and exacerbations."
Which information would the nurse expect the client who has multiple sclerosis with hand tremors to report?
The tremors increase when I perform an activity
Identify the type of hypersensitivity reaction associated with systemic lupus erythematosus (SLE).
Type 3
Which type of hypersensitivity reaction occurs in the client with systemic lupus erythematosus (SLE)?
Type III. Type III hypersensitivity reaction involves immunoglobulin G (IgG)- and IgM-mediated release of neutrophils and monocytes as mediators of injury. An immune complex-mediated hypersensitivity reaction occurs in SLE or rheumatoid arthritis. Allergic rhinitis and asthma may occur when mediators such as histamine and prostaglandins are involved, resulting in a type I hypersensitivity reaction. Type II hypersensitivity reaction is cytotoxic mediated, which occurs in transfusion reaction and Goodpasture syndrome. Type IV hypersensitivity reaction is a delayed hypersensitivity reaction that may occur in contact dermatitis involving T cytotoxic cells.
Which would the nurse identify as increasing the risk of human immunodeficiency virus (HIV) transmission? Select all that apply. One, some, or all responses may be correct.
breast-feeding and childbirth, sharing needles, and unprotected sexual contact
Which diagnostic test result indicates if a client will develop acquired immunodeficiency syndrome (AIDS) from the human immunodeficiency virus (HIV)?
number of CD4+ T cells available
A client with rheumatoid arthritis has been taking a corticosteroid medication for the past year. Prolonged use of corticosteroids puts this client at increased risk for which complication?
Decreased white blood cells
Which long-term outcome would be appropriate for a client with severe rheumatoid arthritis who becomes depressed and is admitted to the psychiatric unit?
Decreases negative thinking about self, others, and life
A client who has multiple sclerosis in remission is a parent of two active preschoolers. Which action would the nurse encourage the client to take?
Develop a flexible schedule for completion of routine daily activities. The client must be flexible and adjust activities to provide for rest when necessary; activity should cease before the point of fatigue. Although quality time with children is important, it must be done on a flexible schedule to prevent fatigue. Although laudable, providing support to other people with multiple sclerosis who also have young children cannot be done if the client is in need of support or if it overtaxes physical resources. Meeting with a self-help group for people with the diagnosis of multiple sclerosis may not be a need at this time; prevention of fatigue always is important.
Which test is used in the diagnosis of systemic lupus erythematosus?
Direct immunofluorescence test. A direct immunofluorescence test is used in the diagnosis of systemic lupus erythematosus. The patch test and photo patch test are used to evaluate allergic dermatitis and photo allergic reactions. An indirect immunofluorescence test is performed on a blood sample.
A client with rheumatoid arthritis arrives in the clinic stating, "I don't take any medications because they are too expensive." The client reports that family members are arranging for the medications to be obtained from another country. Which action would the nurse take first?
Discuss alternative solutions with the client
Which client has findings consistent with rheumatoid arthritis?
ESR 65 mm/hour (Erythrocyte sedimentation rate (ESR) is a nonspecific index of inflammation. Its normal value is less than 30 mm/hr. Client D, who has elevated levels of ESR to 65 mm/hr, may present with rheumatoid arthritis, osteomyelitis, rheumatic fever, or respiratory tract infections)
Which statement by an adolescent during an annual physical examination indicates the need for human immunodeficiency virus (HIV) testing?
I have shared needles when using drugs.
A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statements? Select all that apply. One, some, or all responses may be correct.
I need to report any dark tarry stools, I'll need to stop meds before any scheduled surgery
The nurse develops a teaching plan for a client with rheumatoid arthritis. Which information would the nurse include in the plan about ways to reduce joint stress?
If experiencing pain after 1 to 2 hours of activity, actively take measures to address the pain.
Which legal charge may be brought against the nurse for showing the family of the client results of a human immunodeficiency virus (HIV) test without the consent of the client?
Invasion of privacy
A client who has multiple sclerosis is admitted to the hospital with increasingly frequent and severe exacerbations. One day, the client's partner confides to the nurse, "Life is getting very hard and depressing, and I am upset with myself for thinking about a nursing home." After listening to the partner's concerns, which response would the nurse make?
Joining a support group of people who are coping with this situation may be helpful."
During an exacerbation of multiple sclerosis, a client reports urinary urgency and frequency. Which intervention is the appropriate initial nursing action?
Palpate the suprapubic area of the abdomen
A client with rheumatoid arthritis is in the convalescent stage of an exacerbation. The client states, "The only time I am without pain is when I lie perfectly still." Considering the client's statement, which intervention would the nurse encourage the client to do?
Participate in active joint flexion and extension exercises
A regimen of rest, exercise, and physical therapy is prescribed for a client with rheumatoid arthritis. Which purpose of the regimen would the nurse teach to the client?
Preventing additional joint damage
Which diversion activity would the nurse encourage to meet the client's needs during the remission phase of his or her multiple sclerosis (MS)?
Swimming
Which surgery is used as a prophylactic measure and as a palliative treatment for clients with rheumatoid arthritis (RA)?
Synovectomy
Which intervention is the nurse's priority when caring for a child with human immunodeficiency virus (HIV)?
Protecting the child from infection
Which recommendation would the nurse make to the family of a child with juvenile idiopathic arthritis who has difficulty getting ready for school in the morning due to joint pain and stiffness?
Provide warm, moist heat to the affected joints before arising.
A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. Which reason would the nurse include in a response to this question?
Reduces inflammation
Which type of diet would the nurse expect the primary health care provider to prescribe for a client diagnosed with rheumatoid arthritis?
Regular diet with vitamins and minerals
Which instruction would the nurse share with the client receiving etanercept therapy for rheumatoid arthritis?
Report site reaction (The nurse would teach a client receiving etanercept therapy to report signs of site reaction, because a site reaction is very painful. The nurse would teach a client who is receiving infliximab therapy to report chest pain. Blurry vision does not occur with etanercept. The nurse would teach a client receiving infliximab therapy to report difficulty breathing during intravenous infusion; etanercept is administered subcutaneously)
Which activities would be encouraged of a child with juvenile idiopathic arthritis to prevent loss of joint function? Select all that apply. One, some, or all responses may be correct.
Riding the bicycle, walking to school, swimming in the community pool
The nurse is teaching a school-aged child with juvenile idiopathic arthritis (JIA) activities to prevent the loss of joint function. Which activities would the nurse caution the child to avoid?
Sedentary activities
The circulating nurse in the operating room recently tested positive for the human immunodeficiency virus (HIV). Which action would this nurse implement regarding participation in exposure-prone procedures?
Seek approval circumstances and procedures from a review panel
Which outcome indicates range-of-motion exercises have been effective for a child with juvenile idiopathic arthritis (JIA)?
The knees are more mobile
A client who has passed the acute phase of rheumatoid arthritis is to be out of bed as tolerated. Which type of chair would the nurse use to position the client?
Straight-back armchair
Etanercept is prescribed for an adolescent with juvenile idiopathic arthritis. Which route would the nurse expect to administer the medication?
Subcutaneous
Which consideration is most important when counseling the family of a child with human immunodeficiency virus (HIV)?
Susceptibility to infection
A client who exhibits blurred and double vision and muscular weakness is informed of the diagnosis of multiple sclerosis (MS). The client becomes visibly upset. Which response would the nurse make?
That must have shocked you. Tell me what the health care provider told you about it."
Which criterion would be used to evaluate the effectiveness of range-of-motion exercises for a child with juvenile idiopathic arthritis (JIA)?
The affected joints can flex and extend
Which intervention would reduce the risk of perinatal transmission via vaginal birth in an adolescent who is diagnosed with HIV infection?
Using antiretroviral during the intrapartum perio
Which instructions would the nurse include when teaching a client with multiple sclerosis (MS) about managing urinary retention? Select all that apply. One, some, or all responses may be correct.
Using the Credé maneuve, Monitoring for and reporting signs of urinary tract infection
Corticosteroid therapy is prescribed for a client with multiple sclerosis. In response to the therapy, which symptom would the nurse expect to decrease?
Visual impairmen
The nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which clinical findings to this disease would the nurse expect the client to exhibit? Select all that apply. One, some, or all responses may be correct.
Butterfly facial rash Inflammation of the joints. The connective tissue degeneration of SLE leads to involvement of the basal cell layer, producing a butterfly rash over the bridge of the nose and in the cheek region. Polyarthritis occurs in most clients, with joint changes similar to those seen in rheumatoid arthritis. Firm skin fixed to tissue occurs in scleroderma; in an advanced stage the client has the appearance of a living mummy. Muscle mass degeneration occurs in muscular dystrophy; it is characterized by muscle wasting and weakness. Inflammation of small arteries occurs in polyarteritis nodosa, a collagen disease affecting the arteries and nervous system.
child infected with human immunodeficiency virus (HIV) is admitted with Pneumocystis jiroveci pneumonia and receives trimethoprim/sulfamethoxazole. Which common side effects would the nurse anticipate? Select all that apply. One, some, or all responses may be correct.
Vomiting, crystaluria and photosensitivity
The nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply. One, some, or all responses may be correct.
Wear a large brimmed head, check temperature daily, balance rest with activity
A client asks the nurse, "Should I tell my partner that I just found out I'm human immunodeficiency virus (HIV) positive?" Which is the nurse's most appropriate response?
You are having difficulty deciding what to say
A client recently diagnosed with multiple sclerosis says, "I had planned to get married, but after this diagnosis, I might not be ready." Which response would the nurse make?
You don't feel able to make a decision at this time?"
client admitted to the hospital with an acute episode of rheumatoid arthritis (RA) asks why physical therapy has not been prescribed. Which response would the nurse make
Your joints are still inflamed, and physical therapy can be harmful
Which type of hypersensitivity reaction would the nurse teach a client with rheumatoid arthritis (RA)?
immune complex. RA is an autoimmune disorder associated with an immune-complex type of hypersensitivity reaction. Contact dermatitis caused by poison ivy is associated with a delayed type of hypersensitivity reaction. Goodpasture syndrome is associated with a cytotoxic type of hypersensitivity reaction. Asthma is associated with an IgE-mediated type of hypersensitivity reaction.
A client who has rheumatoid arthritis participates in an individualized exercise program at the extended care facility where the client resides. Which statement from the client indicates to the nurse that the client understands the purpose of the program?
I do one set of exercises slowly after breakfast, then I space the rest of them throughout the day. ( spacing activity protects joints)
A client with painful swelling of a distal joint of the ring finger is diagnosed with the early stages of rheumatoid arthritis (RA). A test for the rheumatoid factor is negative. The client asks about the reliability of the test. Which response would the nurse provide?
Laboratory tests often are negative in the early stages of the disease
A married older adult couple lives independently and has three adult children. The husband, who is alert but forgetful, has an enlarged prostate with infrequent urinary incontinence. The wife has diabetes mellitus, rheumatoid arthritis, and walks with difficulty. The nurse identified the couple's need for assistance with bathing, dressing, and meal preparation. Which option would the nurse suggest, which best meets the needs of this couple?
Keep the couple in their home and schedule assistance with a home health aide.
Which interventions would the nurse include in the plan of care for a client receiving anakinra therapy for rheumatoid arthritis? Select all that apply. One, some, or all responses may be correct.
Monitor the injection site for hypersensitivity reactions every shift and PRN, Monitor client's neutrophil blood cell count before, during, and 3 months after therapy, Before the initial dose, teach the client to report any difficulty in breathing. For the clients receiving anakinra therapy, the nurse would monitor the injection site because site reactions may occur. The nurse would also monitor the neutrophil blood count because the medication can cause a severe decrease in white blood cells, which makes the client more susceptible to infection. The nurse should teach the client to report any difficulty breathing because anakinra can cause serious respiratory infections and various types of cancer. The nurse would monitor the BP in clients who are receiving infliximab therapy. The nurse would teach clients who are receiving infliximab therapy to report chest pain.
The parents of a child with juvenile idiopathic arthritis ask the nurse why their child is not receiving steroid therapy when it is so effective for adults with rheumatoid arthritis. Which response by the nurse is most appropriate?
Steroids could affect growth."
