Chapter 38
A client with osteoarthritis expresses concerns that the disease will prevent the ability to complete daily chores. Which suggestion should the nurse offer?
"pace yourself and rest frequently, especially after activities"
The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?
Celecoxib
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?
hypertension
A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?
NSAIDs
leading cause of disability and pain in the elderly
OA
A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?
OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints
The nurse knows that a patient who presents with the symptom of "blanching of fingers on exposure to cold" would be assessed for what rheumatic disease?
Raynaud's phenomenon
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
Tophi
Which of the following refers to fixation of a joint?
ankylosis
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
administering ordered analgesics and monitoring their effects
Which of the following procedures involves a surgical fusion of the joint?
arthrodesis
What is the priority intervention for a client who has been admitted repeatedly with attacks of gout?
assess diet and activity at home
A client is being treated for hyperuricemia. Part of the treatment strategy is for the client to avoid contributing factors whenever possible. Which activities might bring on an acute attack?
eating organ meats and sardines
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?
elevated erythrocyte sedimentation rate
A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?
facial erythema, pericarditis, pleuritis, fever and weight loss.
The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of
gout
A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not include 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
A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include?
located over bony prominence
A client with ankylosing spondylitis has a stooped position and is being positioned in the bed prior to the nurse taking vital signs. The nurse listens to the client's lungs after positioning. What finding does the nurse hear when listening to lung sounds?
lung sounds are diminished in the apical area
Which joint is most commonly affected in gout
metatarsophalangeal (toe)
A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?
monitor body temperature
A patient is suspected of having myositis. The nurse prepares the patient for what procedure that will confirm the diagnosis?
muscle biopsy
The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management?
strategies for remaining active
synovial fluid
straw like color
The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful?
the belief is that it is an autoimmune disorder with an unknown trigger
The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis?
joint stiffness that decreases with activity
The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care?
increased fatigue
Which of the following would the nurse expect to assess as the most common finding associated with fibromyalgia?
widespread chronic pain
A client with rheumatoid arthritis has experienced increasing pain and progressing inflammation of the hands and feet. What would be the expected goal of the likely prescribed treatment regimen?
minimizing damage
The nurse teach the client that osteoarthritis is
the most common and frequently disabling of joint disorders
Which client is most likely to develop systemic lupus erythematosus (SLE)?
27 year old black female
A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain?
An exercise routine that includes range-of-motion (ROM) exercises
Which is an appropriate nursing intervention in the care of the client with osteoarthritis?
Encourage weight loss and increase in aerobic activity
A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition?
applications of ice
A client arrives at the clinic with reports of pain in the left great toe. The nurse assesses a swollen, warm, erythematous left great toe. What disorder will the nurse relate the client symptoms to?
gout
Osteoarthritis is known as a disease that
is the most common and frequently disabling of joint disorders.
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
methotrexate (Rheumatrex)
A client is recovering from an attack of gout. What will the nurse include in the client teaching?
weight loss will reduce uric acid levels and reduce stress on joints
The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises?
after the client has had a warm paraffin hand bath
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
Has a weight gain of 5 pounds
A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate?
maintain good posture
A nurse is developing a teaching plan for a client diagnosed with osteoarthritis. What instruction should the nurse give to the client to minimize injury?
install safety devices in the home
Which points should be included in the medication teaching plan for a client taking adalimumab?
it is important to monitor for injection site reactions
A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
my finger joints are oddly shaped
The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?
pain
A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?
It will get better and worse again
fibromyalgia is a common condition that involves
chronic fatigue, generalized muscle aching, and stiffness
Which finding is consistent with the diagnosis of rheumatoid arthritis?
cloudy synovial fluid
Which disorder is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks?
Systemic lupus erythematosus (SLE)
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 upset stomach
