Study Inflammation/Immunity
A nurse is assessing a client for early manifestations of rheumatoid arthritis (RA). Which of the following changes is an early manifestation of RA? a. morning stiffness b. fatigue c. temporomandibular joint pain d. baker's cysts
Fatigue Fatigue, weakness, and anorexia are early manifestations of RA. (morning stiffness, Baker's cysts are late manifestations. Temporomandibular joint pain, although rare, is a late manifestation of severe RA.)
A client with a suppressed immune system may report which symptoms? a. Watery eyes and nasal congestion b. Fatigue and poor wound healing c. Rashes and swelling d. Joint pain and impaired walking
b. Fatigue and poor wound healing When the immune system is suppressed, a person will experience fatigue and their wounds will health more slowly as well. The body is exhausted and this is causing you to feel fatigued. When wounds heal slow, they are healing poorly. Your skin goes into damage control mode after you get a burn, cut or scrape. Your body works to protect the wound by sending nutrient-rich blood to the injury to help regenerate new skin. This healing process depends on healthy immune cells. But if your immune system is sluggish, your skin can't regenerate. Instead, your wounds linger and have a hard time healing.
The nurse is caring for a postoperative client. The nurse understands this client should have mild erythema and edema at the incision site 12 to 24 hours post operation depending on which condition? The client/clients: immune system is functioning properly: a. has an infection b. suppressor t-cells are activated c. is properly vaccinated d. immune system is functioning properly
d. immune system is functioning properly. This is related to the pathophysiology of immunity. When the immune system is working well, your body is working to heal itself. With an active immune system, that area where the incision is will experience erythema (redness) and edema (swelling). This is the process of your body not only healing but also building that defense system to help prevent any foreign pathogens from entering the body. Even a very mild fever can be normal post op in that 12-24 hour period due to also the body activating that immune system.
A nurse is teaching a client who is to begin long-term therapy with prednisone to treat rheumatoid arthritis. The nurse should instruct the client to take which of the following supplements while taking this medication? a. calcium and vitamin d b. biotin and vitamin b2 c. folic acid and vitamin c d. pantothenic acid and vitamin b6
a. Calcium and vitamin D Long-term use of glucocorticoids, such as prednisone, places the client at risk for osteoporosis. The nurse should instruct the client to take calcium and vitamin D supplements to reduce this risk.
A nurse is providing discharge instructions to a parent and his school age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include? a. encourage the child to take a 45 min nap daily b. allow the child to stay home on days when her joints are painful c. apply cool compresses for 20 mins every hours d. administer prednisone on an alternate-day schedule
d. Administer prednisone on an alternate-day schedule. Prednisone is an effective anti-inflammatory agent that can have serious adverse effects. Taking prednisone on an alternate-day schedule can help maintain joint mobility and minimize adverse effects.
A nurse is teaching a client who has rheumatoid arthritis about increasing physical rest as part of her treatment plan. Which of the following outcomes of this intervention should the nurse document as a goal for this client? a. reduce joint stress b. maintenance of joint function c. suppression of the inflammatory process d. decrease stiffness
a. Reduced joint stress Rheumatoid arthritis in an autoimmune disease in which the cartilage and bone of the joints are destroyed resulting in increased pain and limited range of motion. The nurse should instruct the client that rest reduces stress on the joints and can be an effective intervention for relieving pain associated with rheumatoid arthritis.
A deformity that is common in clients with osteoarthritis (OA) is: a. ulnar drift b. heberden's node c. swan neck deformity d. hallux valgus
b. Heberden's nodes Heberden's nodes is a common deformity seen in patients with OA. Swan neck deformity, ulnar drift, and hallux valgus are all rheumatoid arthritis (RA) deformities.
A nurse in a provider's office is assessing a client who has rheumatoid arthritis (RA). Which of the following findings is a late manifestation of this condition? a. anorexia b. knuckle deformity c. low grade fever d. weight loss
b. Knuckle deformity Joint deformity is a late manifestation of RA. (weight loss, low grade fever, and anorexia are all early manifestations)
A nurse is caring for a school aged child who has juvenile idiopathic arthritis (JIA). Which of the following home care instructions will the nurse include in the teaching for the parents? a. pursue normal activities as a family unit b. administer naproxen on an empty stomach c. apply cold compresses for joint pain d. Perform ROM exercises immediately upon wakening in the morning.
a. Pursue normal activities as a family unit. To prevent isolation and foster independence, the family is encouraged to pursue their normal activities. It takes resourcefulness and commitment from all family members to support the child with JIA. Heat has been shown to be beneficial to children with JIA. Moist heat is best for relieving pain and stiffness. A warm bath is the most practical method to decrease pain and/or stiffness of the joints. NSAID's must be taken with a meal or snack to decrease gastrointestinal irritation (GI upset). The child should awaken approximately one hour early and take pain medication. After the pain medication is working, then they can start with their ROM exercises. Yoga, tai chi, and water aerobics are excellent therapies to preserve function and/or prevent deformity.
A nurse in a medical clinic is providing teaching to an older adult client who has osteoarthritis that is affecting her knees. Which of the following client statements indicated an understanding of the teaching? a. "I will elevate my legs by placing two pillows under my knees when I go to bed." b. "I should limit further activity to prevent further injury." c. "Ibuprofen is the first step in medication therapy for osteoarthritis." d. "I can use heat to help with joint stiffness."
c. Ibuprofen is the first step in medication therapy for osteoarthritis. Ibuprofen is often the initial medication given to help decrease inflammation and pain. Heat can help lessen joint stiffness, but this answer is wrong because you need to alternate between heat and cold therapies is an intervention. Patients can limit their activity but the reason this answer is wrong is because limiting activity is NOT going to prevent further injury. Elevating their legs relates more to lessen edema in the lower extremities. Placing a pillow underneath the knees will help alleviate back pain but will not help alleviate knee pain from OA.
