Common concept - Ch. 38 Assessment and Management of Patients with Rheumatic Disorders workbook

The single, most important medication for the treatment of systemic SLE is

corticosteroids

A purine-restricted diet is prescribed for a patient. The nurse should recommend

dairy products

Blood testing will be ordered to determine the presence of

severe anemia, thrombocytopenia, leukocytosis, leukopenia, and positive antinuclear antibodies

To immobilize an inflamed wrist, the nurse should splint the joint in a position of:

slight dorsiflexion

A serum study that is positive for the rheumatoid factor is

suggestive of RA

In RA, the autoimmune reaction primarily occurs in the

synovial tissue

The nurse knows that the physician may order _______ medications for treating SLE if the symptoms are mild.

antimalarial

The most common type of disabling connective tissue disease in the US is

degenerative joint disease

Drug-induced side effects from a low-dose corticosteroids

*Elevated blood pressure *Weight gain *Gastric upset

A popular and effective COX-2 inhibitor that increases the patient's risk of stroke is

Celebrex

A patient is suspected of having myositis. The nurse prepares the patient for what procedure that will confirm the diagnosis?

Muscle biopsy

A disease-modifying antirheumatic drug (DMARD) that is successful in the treatment of RA yet has retinal eye changes as a side effect is

Plaquenil

The nurse knows that a patient diagnosed with a spondyloarthropathy would not have

Raynaud's phenomenon

The nurse knows that a patient who is present with the symptom of "blanching of his fingers on exposure to cold" would be assessed for the rheumatic disease known as

Raynaud's phenomenon

A characteristic cutaneous lesion, called the "butterfly rash", appears across the bridge of the nose in 50% of patients with

Systemic Lupus Erythematosus (SLE)

Gold-containing compounds act by inhibiting

T and B cell activity.

In the inflammatory process in rheumatic diseases, a triggering even (trauma, stress) starts the process by activating:

T lymphocytes

The altered immune response can be described as

an increase in autoantibody production results from abnormal suppressor T-cell function, leading to immune complex deposition and tissue damage

The RA reaction produces enzymes that break down:

collagen

As part of health teaching, the nurse reminds the patient that possible cardiovascular complications require periodic screening for

hypertension and atherosclerotic heart disease

With a diagnosis of gout, a nurse should expect to find

hyperuricemia

Synovial fluid from an inflamed joint is characteristically:

milky, cloudy, and dark yello

The most common symptom of rheumatic disease that causes a patient to seek medical attention is

pain

In RA, the cartilage is replaced with fibrous connective tissue during the stage of synovial joint destruction known as

pannus formation

When a person with arthritis is temporarily confined to bed, the position recommended to prevent flexion deformities is

prone

The systemic features usually found with RA

*weight loss, fever, anemia, fatigue, lymph node enlargement, and Raynaud's phenomenon

Nonsteroidal anti-inflammatory drugs (NSAIDs) used in rheumatic diseases include all of the following except

Cytoxan

All of the following blood studies (positive C-reactive protein (CRP), positive antinuclear antibody (ANA), serum complement level (C3) of >130 mg/dL) are consistent with a positive diagnosis of RA except

red blood cell count of <4.0 million/uL

The etiology of SLE is an altered immune regulation that can be caused by disturbances in

*chemical *hormonal *environment *genetic

Clinical manifestations of scleroderma include

*decreased ventilation owing to lung scarring *dysphagia owing to hardening of the esophagus *dyspnea owing to fibrotic cardiac tissue

Pathophysiologic changes seen with osteoarthritis include:

*joint cartilage degeneration *the formation of bony spurs at the edges of the joint surfaces *narrowing of the joint space

The nurse is aware the physician will do a complete cardiovascular assessment, checking the patient for

*pericardial friction rub *myocarditis *pericarditis

Match the clinical interpretation/laboratory significance listed with its associated test

*Uric acid - An increase in the substance is seen with gout *Complement - This protein substance is decreased in RA and SLE *Rheumatoid factor - This is present in 80% of those who have RA *Hematocrit - A decrease can be seen in chronic inflammation *HLA-B27 antigen - This is present in 85% of those with ankylosing spondylitis *Antinuclear antibody (ANA) - A positive test is associated with SLE, RA, and Raynaud's disease *Creatinine - An increase may indicate renal damage, as in scleroderma *C-Reactive protein (CRP) - Frequently positive for RA and SLE