463 Final
A patient who requires daily use of a nonsteroidal antiinflammatory drug (NSAID) for the management of severe rheumatoid arthritis has recently developed melena. The nurse will anticipate teaching the patient about
cytotec and protection of GI mucosa
What concern should the nurse anticipate for a patient who had a right hemisphere stroke?
denial/impulsive
A patient being admitted with a stroke has right-sided facial drooping and right-sided arm and leg paralysis. Which finding should the nurse expect?
difficulty comprehending instructions
A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat redistribution to the trunk with wasting of the arms, legs, and face. What recommendation will the nurse give to the patient?
discuss changes in therapy
Which result for a patient with systemic lupus erythematosus (SLE) is most important for the nurse to communicate to the health care provider?
elevated BUN
Eight years after seroconversion, a patient with human immunodeficiency virus infection has a CD4+ cell count of 800/μL and an undetectable viral load. What should be included in the plan of care at this time?
encourage adequate diet and exercise
Which action will the nurse include in the plan of care for a patient with a new diagnosis of rheumatoid arthritis (RA)?
encourage the pt to take afternoon naps
The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be appropriate for the nurse to take?
expected finding
FAST
face, arms, speech, time
labs to watch with RA
glucose, sodium, potassium
A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving a prescribed dose of aspirin?
headache
scans
hemorrhagic= ct will be + ischemic= MRI will be + TIA= both -
right sided strok
impaired judgment, impulsive, agnosia, depression, language
left sided stroke
impaired memory, aphasia
What topic should the nurse anticipate teaching a patient who had a brief episode of tinnitus, diplopia, and dysarthria with no residual effects?
low dose aspirin
An older adult who takes medications for coronary artery disease and hypertension is newly diagnosed with HIV infection and is starting antiretroviral therapy. Which information will the nurse include in patient teaching?
many drug interactions
symptom management RA
methotrexate (chemo drug for acute exacerbation), prednisone, vegetarian, NSAID
how will a TIA present
negative CT/MRI, symptoms resolve in 48-72 hours
common issue with lupus
nephritis, watch urine output, pericarditis
A patient with carotid atherosclerosis asks the nurse to describe a carotid endarterectomy. Which response by the nurse is accurate?
plaque is surgically removed
A patient in the emergency department with sudden-onset right-sided weakness is diagnosed with an intracerebral hemorrhage. Which information about the patient is most important to communicate to the health care provider?
pt has afib and takes warfarin
Which patient who has arrived at the human immunodeficiency virus (HIV) clinic should the nurse assess first?
pt who had 10 liquid stools
how to diagnose RA
rheumatoid factor >30
nursing lupus
risk for impaired skin integrity
plan with stroke
rule out/in hemorrhagic then treat occlusive, if neither= TIA
hemorrhagic stroke
severe, ruptured blood vessel causes bleeding (15%), progress over time
When the nurse brings medications to a patient with rheumatoid arthritis, the patient refuses the prescribed methotrexate. The patient tells the nurse, ―My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis.‖ The most appropriate response by the nurse is
start it early
A patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously. Health records show a history of several transient ischemic attacks (TIAs). What should the nurse anticipate for this patient?
tPa infusion
TIA
temporary clot, pre-stroke
The home health nurse is making a follow-up visit to a patient with recently diagnosed rheumatoid arthritis (RA). Which assessment made by the nurse indicates more patient teaching is needed
the pt sleeps with two pillows under their head
A 29 - yr - old woman is taking methotrexate to treat rheumatoid arthritis. Which information from the patient's health history is important for the nurse to report to the health care provider related to the methotrexate
trying to get pregnant
The health care provider has prescribed the following interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question?
varicella vaccine
During change of shift report, a nurse is told that a patient has an occluded left posterior cerebral artery. What finding should the nurse anticipate?
visual deficits
how quick for tpa
within 60 mins
RA nursing
chronic pain, impaired mobility, body image
test for lupus
ANA, if >1.1
skin in lupus
butterfly rash
finger with lupus
swan fingers
A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific findings for the nurse to review?
Anti-Smith antibody (Anti-Sm)
what will be elevated 48 hours after stroke
BP
Which laboratory result will the nurse monitor to determine if prednisone has been effective for a patient with an acute exacerbation of rheumatoid arthritis?
C-reactive protein
first test for stroke
CT
Which intervention should the nurse include in the plan of care for a patient with new right-sided homonymous hemianopsia after a stroke?
Place needed objects on the patient's left side.
A patient informed of a positive rapid screening test result for human immunodeficiency virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the nurse is most important at this time?
Remind the patient to return for retesting to verify the results.
The nurse is advising a patient who was exposed 4 days ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient's antigen-antibody test has just been reported as negative for HIV. What information should the nurse give to this patient?
You will need to be retested in 2 weeks
The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with
a warm bath
A 70-yr-old female patient with left-sided hemiparesis arrives by ambulance to the emergency department. Which action should the nurse take first?
check respirations
risk for ischemic stroke
afib
Which information about a patient population would be most useful to help the nurse plan for human immunodeficiency virus (HIV) testing needs?
age
What instructions about plasmapheresis should the nurse include in the teaching plan for a patient diagnosed with systemic lupus erythematosus (SLE)
antibody-antigen complex
A patient has a ruptured cerebral aneurysm and subarachnoid hemorrhage. Which intervention will the nurse include in the plan of care?
apply SCD
Which information will the nurse include when preparing teaching materials for a patient with an exacerbation of rheumatoid arthritis?
apply cold packs
A female patient who had a stroke 24 hours ago has expressive aphasia. What is an appropriate nursing intervention to help the patient communicate?
ask yes/no questions
A patient in the clinic reports a recent episode of dysphasia and left-sided weakness at home that resolved after 2 hours. What topic should the nurse anticipate teaching the patient?
aspirin
A patient being seen in the clinic has rheumatoid nodules on the elbows. Which action will the nurse take?
assess nodules for skin breakdown
A patient will attempt oral feedings for the first time after having a stroke. After assessing the gag reflex, what action should the nurse take?
assist pt into chair
A left-handed patient with left-sided hemiplegia has difficulty feeding himself. Which intervention should the nurse include in the plan of care?
assit pt to eat with right hand
The nurse teaching a support group of women with rheumatoid arthritis (RA) about how to manage activities of daily living suggests they should
avoid activities requiring repetitive use
what can cause lupus flare ups
birth control, pregnancy, stress, sun
Ischemic stroke
blood clot/plaque that occludes blood flow (85%),immediate onset
most severe type of stroke
brain stem- autonomic function, heart beat, breathing
