Rheumatoid arthritis
A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage? A. Hydroxychloroquine (Plaquenil) B. Lefluomide (Arava) C. Sulfasalazine (Azulfidine) D. Methylprednisolone (Medrol)
A. Hydroxychloroquine (Plaquenil)
Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)? Select all that apply. 1. Adults between the ages of 20 and 50 years. 2. Adults who have had an infectious disease with the Epstein-Barr virus. 3. Adults that are of the male gender. 4. Adults who possess the genetic link, specifically HLA-DR4. 5. Adults who also have osteoarthritis.
1, 2, 4.Rheumatoid arthritis (RA) affects women three times more often than men, between the ages of 20 and 55 years. Research has determined that RA occurs in clients who have had infectious disease, such as the Epstein-Barr virus. The genetic link, specifically HLA-DR4, has been found in 65% of clients with RA. People with osteoarthritis are not necessarily at risk for developing rheumatoid arthritis.
After teaching the client with severe rheumatoid arthritis about prescribed methotrexate (Rheumatrex), which of the following statements indicates the need for further teaching? 1. "I will take my vitamins while I'm on this drug." 2. "I must not drink any alcohol while I'm taking this drug." 3. "I should brush my teeth after every meal." 4. "I will continue taking my birth control pills."
1. "I will take my vitamins while I'm on this drug."
1. A nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (Select all that apply.) A. Recent influenza B. Decreased range of motion C. Hypersalivation D. Increased blood pressure E. Pain at rest
1. A. CORRECT: Exacerbating factors, such as a recent illness like influenza, are indicative in clients who have RA. B. CORRECT: A decrease in range of motion is indicative in clients who have RA. C. Clients who have RA can experience xerostomia, not hypersalivation. D. Increased blood pressure is not indicative of RA. E. CORRECT: Pain at rest is indicative of RA. NCLEX® Connection: Physiological Adaptation, Pathophysiology
A client with rheumatoid arthritis states, "I can't do my household chores without becoming tired. My knees hurt whenever I walk." Which nursing diagnosis would be most appropriate? 1. Activity intolerance related to fatigue and pain. 2. Self-care deficit related to increasing joint pain. 3. Ineffective coping related to chronic pain. 4. Disturbed body image related to fatigue and joint pain.
1.Based on the client's complaints, the most appropriate nursing diagnosis would be Activity intolerance related to fatigue and pain. Nursing interventions would focus on helping the client conserve energy and decrease episodes of fatigue. Although the client may develop a self-care deficit related to the activity intolerance and increasing joint pain, the client is voicing concerns about household chores and difficulty around the house and yard, not self-care issues. Over time, the client may develop ineffective coping or body image disturbance as the disorder becomes chronic with increasing pain and fatigue.
Adalimumab (Humira) is given to a client for the treatment of rheumatoid arthritis. Which of the following side effect is associated with the medication? A. Numbness. B. Diarrhea. C. Urinary retention. D. Weight gain.
A. Numbness. Adalimumab (Humira) has been associated with neurological side effects such as numbness, tingling, dizziness, visual disturbances, and weakness in the legs).
2. A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching? SATA A. "You can experience morning stiffness when you get out bed." B. "You can experience abdominal pain." C."You can experience weight gain." D."You can experience low blood sugar."
2. A. CORRECT: The nurse should include in the teaching that the client who has RA can experience stiffness in her joints upon rising. B. The client who has RA can experience pleuritic pain upon inspiration, not abdominal pain. C. The client who has RA can experience weight loss, not weight gain. D. The client who has RA does not experience a low blood sugar. NCLEX® Connection: Physiological Adaptation, Illness Management
A 25-year-old client taking hydroxychloroquine (Plaquenil) for rheumatoid arthritis reports difficulty seeing out of her left eye. Correct interpretation of this assessment finding indicates which of the following? 1. Development of a cataract. 2. Possible retinal degeneration. 3. Part of the disease process. 4. A coincidental occurrence.
2. Possible retinal degeneration.
A physician suspects a patient may have rheumatoid arthritis due to the patient's presenting symptoms. What diagnostic testing can be ordered to help a physician diagnose rheumatoid arthritis? Select all that apply: A. Rheumatoid factor B. Uric acid level C. Erythrocyte sedimentation D. Dexa-Scan E. X-ray imaging
A. Rheumatoid factor C. Erythrocyte sedimentation E. X-ray imaging
3. A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory tests are used to diagnose this disease? (Select all that apply.) A. Urinalysis B. Erythrocyte sedimentation rate (ESR) C. BUN D. Antinuclear antibody (ANA) titer E. WBC count
3. A. A urinalysis is not a laboratory test used to diagnose RA. This test can used for detecting kidney failure. B. CORRECT: ESR is a laboratory test used to diagnose RA. This laboratory test will show an elevated result in clients who have RA. C. A BUN is not a laboratory test used to diagnose RA. This test can be used for detecting kidney failure. D. CORRECT: ANA titer is a laboratory test used to diagnose RA. This laboratory test will show a positive result in clients who have RA. E. CORRECT: WBC count is a laboratory test used to diagnose RA. This laboratory test will show a decreased result in clients who have RA. NCLEX® Connection: Reduction of Risk Potential, Diagnostic Tests
On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse should conduct a focused assessment for: 1. Limited motion of joints. 2. Deformed joints of the hands. 3. Early morning stiffness. 4. Rheumatoid nodules.
3. Early morning stiffness. Initially, most clients with early symptoms of rheumatoid arthritis complain of early morning stiffness or stiffness after sitting still for a while. Later symptoms of rheumatoid arthritis include limited joint range of motion; deformed joints, especially of the hand; and rheumatoid nodules.
The nurse teaches a client about heat and cold treatments to manage arthritis pain. Which of the following client statements indicates that the client still has a knowledge deficit? 1. "I can use heat and cold as often as I want." 2. "With heat, I should apply it for no longer than 20 minutes at a time." 3. "Heat-producing liniments can be used with other heat devices." 4. "Ten to 15 minutes per application is the maximum time for cold applications."
3.Heat-producing liniment can produce a burn if used with other heat devices that could intensify the heat reaction. Heat and cold can be used as often as the client desires. However, each application of heat should not exceed 20 minutes, and each application of cold should not exceed 10 to 15 minutes. Application for longer periods results in the opposite of the intended effect: vasoconstriction instead of vasodilation with heat, and vasodilation instead of vasoconstriction with cold.
A client is in the acute phase of rheumatoid arthritis. Which of the following should the nurse identify as lowest priority in the plan of care? 1. Relieving pain. 2. Preserving joint function. 3. Maintaining usual ways of accomplishing tasks. 4. Preventing joint deformity.
3.Maintaining usual ways of accomplishing tasks would be the lowest priority during the acute phase. Rather, the focus is on developing less stressful ways of accomplishing routine tasks. Pain relief is a high priority during the acute phase because pain is typically severe and interferes with the client's ability to function. Preserving joint function and preventing joint deformity are high priorities during the acute phase to promote an optimal level of functioning and reduce the risk of contractures.
A client with rheumatoid arthritis tells the nurse, "I know it is important to exercise my joints so that I won't lose mobility, but my joints are so stiff and painful that exercising is difficult." Which of the following responses by the nurse would be most appropriate? 1. "You are probably exercising too much. Decrease your exercise to every other day." 2. "Tell the physician about your symptoms. Maybe your analgesic medication can be increased." 3. "Stiffness and pain are part of the disease. Learn to cope by focusing on activities you enjoy." 4. "Take a warm tub bath or shower before exercising. This may help with your discomfort."
4. "Take a warm tub bath or shower before exercising. This may help with your discomfort."
The client with rheumatoid arthritis tells the nurse, "I have a friend who took gold shots and had a wonderful response. Why didn't my physician let me try that?" Which of the following responses by the nurse would be most appropriate? 1. "It's the physician's prerogative to decide how to treat you. The physician has chosen what is best for your situation." 2. "Tell me more about your friend's arthritic condition. Maybe I can answer that question for you." 3. "That drug is used for cases that are worse than yours. It wouldn't help you, so don't worry about it." 4. "Every person is different. What works for one client may not always be effective for another."
4. "Every person is different. What works for one client may not always be effective for another." The nurse's most appropriate response is one that is therapeutic. The basic principle of therapeutic communication and a therapeutic relationship is honesty. Therefore, the nurse needs to explain truthfully that each client is different and that there are various forms of arthritis and arthritis treatment. To state that it is the physician's prerogative to decide how to treat the client implies that the client is not a member of his or her own health care team and is not a participant in his or her care. The statement also is defensive, which serves to block any further communication or questions from the client about the physician. Asking the client to tell more about the friend presumes that the client knows correct and complete information, which is not a valid assumption to make. The nurse does not know about the client's friend and should not make statements about another client's condition. Stating that the drug is for cases that are worse than the client's demonstrates that the nurse is making assumptions that are not necessarily valid or appropriate. Also, telling the client not to worry ignores the underlying emotions associated with the question, totally discounting the client's feelings.
After teaching the client with rheumatoid arthritis about measures to conserve energy in activities of daily living involving the small joints, which of the following, if stated by the client, would indicate the need for additional teaching? 1. Pushing with palms when rising from a chair. 2. Holding packages close to the body. 3. Sliding objects. 4. Carrying a laundry basket with clenched fingers and fists.
4. Carrying a laundry basket with clenched fingers and fists.
A patient with severe rheumatoid arthritis is scheduled for a procedure called an arthrodesis. The nursing student you are precepting asks what type of procedure this is. Your response is: A. "It is a procedure where the affected joint is removed and each end of the bones found within that joint are fused together." B. "It is a procedure that involves replacing the joint with an artificial one." C. "It is a procedure where the surgeon goes in with a scope and cleans out the affected joint." D. "It is a procedure where the synovium is completely removed within the joint, which helps decrease inflammation of the joint.
A. "It is a procedure where the affected joint is removed and each end of the bones found within that joint are fused together."
ou're providing care to a patient with severe rheumatoid arthritis. While performing the head-to-toe nursing assessment, you note the patient's overall skin color to be pale and the patient looks exhausted. You ask the patient how she is feeling, and she says "I'm so tired. I can't even get out of this bed without getting short of breath." Which finding on the patient's morning lab work may confirm a complication that can be experienced with rheumatoid arthritis? A. Potassium 3.2 mEq/L B. Hemoglobin 7 g/dL C. Sodium 135 mEq/L D. WBC count 6,500
B. Hemoglobin 7 g/dL
Disease-modifying antirheumatic drugs (DMARDS) are used to treat rheumatoid arthritis. Select-all-the drugs below that are DMARDS: A. Dexamethasone (Decadron) B. Hydroxychloroquine (Plaquenil) C. Teriparatide (Forteo) D. Calcitonin E. Leflunomide (Arava) F. Methotrexate (Trexall)
B. Hydroxychloroquine (Plaquenil) E. Leflunomide (Arava) F. Methotrexate (Trexall)
4) The nurse is collecting a health history for a client being seen in an outpatient clinic. The client complains of joint pain and swelling that have lasted for about 2 months. The nurse devises a plan of care based on the nursing diagnosis of Activity Intolerance based on which client statement? A) "I seem to get tired early in the day and require a nap." B) "My joints are stiffest at night before I go to sleep." C) "I find it difficult to move when I first get up in the morning." D) "I take ibuprofen for the pain as needed."
Answer: A Explanation: A) One hallmark of RA is extreme fatigue, and the nurse would plan to teach the client about frequent rest periods during the day to conserve energy. The client with RA will be stiff early in the morning, but that would not interfere with activities later in the day. Joints of the RA client are stiffest in the morning. Taking ibuprofen for pain does not affect the ability for activity. Page Ref: 505 Cognitive Level: Applying Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 4. Formulate priority nursing diagnoses appropriate for an individual with rheumatoid arthritis.
5) The nurse is completing a health screening for a school-age child with rheumatoid arthritis. The parents ask the nurse to recommend activities that will promote exercise for their child. Which is an appropriate recommendation by the nurse? A) Swimming B) Football C) Softball D) Basketball
Answer: A Explanation: A) Swimming exercises all the extremities without putting undue stress on joints. Softball, football, or basketball could exacerbate joint discomfort. Page Ref: 504 Cognitive Level: Applying Client Need: Health Promotion and Maintenance Nursing Process: Implementation Learning Outcome: 3. Illustrate the nursing process in providing culturally competent care across the life span for individuals with RA.
1) A 43-year-old woman, recently diagnosed with RA, asks the nurse whether she might have concerns beyond the problems with her joints. The nurse informs her that RA may also involve: Select all that apply. A) The respiratory system. B) The cardiovascular system. C) The exocrine system. D) The reproductive system. E) The hematologic system.
Answer: A, B, C, E Explanation: A) RA can result in pleural effusion (collection of fluid in the pleural space). Individuals with RA have an increased risk of developing coronary heart disease. RA is a systemic disease of connective tissue that can affect exocrine glands, resulting most frequently in dry eyes and mouth. Properly managed, rheumatoid arthritis is not considered to be a danger for pregnant women or their babies. Patients with RA may suffer from a variety of hematologic disorders, particularly anemia. Page Ref: 495 Cognitive Level: Analyzing Client Need: Physiological Integrity Nursing Process: Analysis Learning Outcome: 1. Describe the pathophysiology, etiology, clinical manifestations, and direct and indirect causes of rheumatoid arthritis (RA).
10) A nurse is caring for a client who has been newly diagnosed with rheumatoid arthritis (RA). The client asks the nurse what the difference is between rheumatoid arthritis and osteoarthritis (OA). The nurse's best response includes: Select all that apply. A) "The onset of OA is gradual while the onset of RA may be rapid." B) "With OA, multiple joints are symmetrically affected; RA affects one joint at a time." C) "The affected joints in RA feel cold to the touch while the joints affected by OA are warm or hot to the touch." D) "OA is slowly progressive while RA is characterized by exacerbations and remissions." E) "The pain and stiffness with RA is with activity; OA pain and stiffness is predominant upon arising."
Answer: A, D Explanation: A) The onset of OA is gradual while the onset of RA may be rapid. RA affects multiple joints symmetrically while OA affects one joint at a time. The affected joints in OA feel cold to the touch while the joints affected by RA are warm or hot to the touch. OA is slowly progressive while RA has exacerbations and remissions. Pain associated with RA is predominant upon arising versus the pain in OA, which is with activity. Page Ref: 495 Cognitive Level: Understanding Client Need: Physiological Integrity Nursing Process: Assessment Learning Outcome: 1. Describe the pathophysiology, etiology, clinical manifestations, and direct and indirect causes of rheumatoid arthritis (RA).
2) A client has just recently been diagnosed with rheumatoid arthritis (RA). The client asks the nurse if RA always causes crippling deformities. The nurse tells the client that to decrease the likelihood of deformities, it is important to: Select all that apply. A) Ignore pain as a warning signal. B) Type instead of hand-writing items if possible. C) Use stronger joints for most activity. D) Avoid stress to any current area of deformity. E) Stop an activity if it is beyond your ability to perform.
Answer: B, C, D, E Explanation: A) The client with RA should never attempt to push a joint beyond its ability. Writing requires using a strong grip, so typing is preferable. Using a stronger joint or part of the body, such as the palm, to carry items is preferable to grasping. Pain is a warning signal, and the client with RA should stop any activity that causes pain. When performing a task, the client should avoid stress in the area of the deformity to help prevent further deformities. Page Ref: 505 Cognitive Level: Applying Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 2. Identify risk factors and prevention methods associated with RA.
8) A nurse is caring for a client who was admitted to the hospital with an exacerbation of rheumatoid arthritis. The client states that her pain is a 3 on a scale from 1 to 10 today. What non-pharmacological interventions can the nurse provide? Select all that apply. A) Discourage any position changes. B) Relaxation techniques C) Immobilize the extremity. D) Massage E) Provide diversion activities.
Answer: B, D, E Explanation: A) Non-pharmacological activities for pain relief include massage, relaxation, and diversion. Position changes are encouraged along with supportive equipment. Immobilization would likely cause contractures in the joints. Page Ref: 504 Cognitive Level: Applying Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 6. Plan evidence-based care for an individual with RA and his or her family in collaboration with other members of the healthcare team.
6) A client with rheumatoid arthritis is being seen in the outpatient clinic for a progress check-up. The nurse is reviewing the client's plan of care and determines that the client has met a goal of treatment when the client makes which statement? A) "I sleep for 10 hours at night." B) "I have increased pain in my joints all the time now." C) "I have delegated many household chores to my children and spouse." D) "I do not perform household chores at all anymore."
Answer: C Explanation: A) One technique for reducing stress on the joints is to delegate household tasks to family members. The client does not need to refrain from all household chores. Sleeping for 10 hours at night will not alleviate the need for frequent rest periods during the day. Increased joint pain would indicate that goals have not been met. Page Ref: 507 Cognitive Level: Applying Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 7. Evaluate expected outcomes for an individual with RA.
3) A female client who was recently diagnosed with rheumatoid arthritis (RA) asks the nurse if the cause of the disease is the fact that her family is of Hispanic descent. Which is the most appropriate response by the nurse to this client? A) "RA affects those of German descent most often." B) "RA is most prevalent in Caucasian females." C) "RA is most prevalent in men under the age of 20 years." D) "RA affects all races at the same rate."
Answer: D Explanation: A) RA affects 12% of the total population across all races. It affects women 3 times more than men, and the onset is usually between the ages of 20 and 40 years. Page Ref: 496 Cognitive Level: Applying Client Need: Psychosocial Integrity Nursing Process: Implementation Learning Outcome: 3. Illustrate the nursing process in providing culturally competent care across the life span for individuals with rheumatoid arthritis.
7) The nurse is caring for a client who was diagnosed with rheumatoid arthritis last year. The client has recently been placed on prednisone for treatment. The nurse is teaching the client about safe medication administration. Which client statement indicates that the medication teaching was successful? A) "I will not have to limit my consumption of canned vegetables." B) "I will take this medication on a full stomach to enhance absorption." C) "I will not need to monitor my blood sugar more frequently while on this medication." D) "I will take the ordered dose at the same time every day."
Answer: D Explanation: A) Steroid therapy is usually done as part of a tapered-dose treatment plan. It is important to take the medication at the same time each day. Steroids are taken with food to minimize GI distress, not to enhance absorption. Steroids can cause fluid retention, so sodium intake should be limited. A hidden source of sodium is canned vegetables. Steroids also increase blood sugar, so blood sugar may need to be monitored more frequently while on the medication regimen. Page Ref: 502 Cognitive Level: Applying Client Need: Physiological Integrity Nursing Process: Implementation Learning Outcome: 5. Summarize therapies used by interdisciplinary teams in the collaborative care of an individual with RA.
9) A nurse is caring for a pregnant client who has rheumatoid arthritis (RA). The nurse understands that this client may: A) Be at higher risk for preterm delivery. B) Not stop medication for RA, even if the client is in remission. C) Experience a relapse during pregnancy, often followed by a remission after delivery. D) Be anemic as a result of blood loss from salicylate therapy.
Answer: D Explanation: A) The pregnant client with RA may have prolonged gestations and often experience a remission during pregnancy and relapse after delivery. The pregnant client with RA that is in remission may stop medication. This client may be anemic as a result of blood loss from salicylate therapy. Page Ref: 497 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Nursing Process: Planning Learning Outcome: 3. Illustrate the nursing process in providing culturally competent care across the life span for individuals with RA.
Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the following side effects indicates an overdosage of the medication? A. Flushing. B. Dizziness. C. Joint pain. D. Metallic taste.
Answer: D. Metallic taste. Gold sodium thiomalate toxicity signs are pruritus, diarrhea, dermatitis, stomatitis, and metallic taste.
During a routine health check-up visit a patient states, "I've been experiencing severe pain and stiffness in my joints lately." As the nurse, you will ask the patient what questions to assess for other possible signs and symptoms of rheumatoid arthritis? Select-all-that-apply: A. "Does the pain and stiffness tend to be the worst before bedtime?" B. "Are you experiencing fatigue and fever as well?" C. "Is your pain and stiffness symmetrical on the body?" D. "Is your pain and stiffness aggravated by extreme temperature changes?"
B. "Are you experiencing fatigue and fever as well?" C. "Is your pain and stiffness symmetrical on the body?"
You are providing education to a patient, who was recently diagnosed with rheumatoid arthritis, about physical exercise. Which statement made by the patient is correct? A. "It is best I try to incorporate a moderate level of high impact exercises weekly into my routine, such as running and aerobics." B. "I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a weekly regime of range of motion exercises along with walking and riding a stationary bike." C. "It is important I perform range of motion exercises during joint flare-ups and incorporate low-impact exercises into my daily routine." D. "Physical exercise should be limited to only range of motion exercises to prevent further joint damage."
B. "I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a weekly regime of range of motion exercises along with walking and riding a stationary bike."
. A 58 year old female is experiencing a flare-up with rheumatoid arthritis. While assisting the patient with her morning routine, the patient verbalizes a pain rating of 7 on 1-10 scale in the right and left wrist along with severe stiffness. You note the wrist joints to be red, warm, and swollen. What nonpharmalogical nursing interventions can you provide to this patient to help alleviate pain and stiffness? Select-all-that-apply: A. Exercise the affected joints B. Assist the patient with a warm shower or bath C. Perform deep massage therapy to the wrist joints D. Assist the patient with applying wrist splints
B. Assist the patient with a warm shower or bath D. Assist the patient with applying wrist splints
You're providing care to a patient with severe rheumatoid arthritis. While performing the head-to-toe nursing assessment, you note the patient's overall skin color to be pale and the patient looks exhausted. You ask the patient how she is feeling, and she says "I'm so tired. I can't even get out of this bed without getting short of breath." Which finding on the patient's morning lab work may confirm a complication that can be experienced with rheumatoid arthritis? A. Potassium 3.2 mEq/L B. Hemoglobin 7 g/dL C. Sodium 135 mEq/L D. WBC count 6,500
B. Hemoglobin 7 g/dL
The classic signs and symptoms of rheumatoid arthritis include which of the following? A. Pain on weight-bearing, rash and low-grade fever. B. Joint swelling, joint stiffness in the morning and bilateral joint movement. C. Crepitus, development of Heberden's nodes and anemia. D. Fatigue, leucopenia and joint pain.
B. Joint swelling, joint stiffness in the morning and bilateral joint movement.
. A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to? A. Clay-colored stool is a normal response of the treatment. B. Pregnancy is not contraindicated with the use of the medication. C. Strict hand washing. D. Get a daily source of sunlight during the day.
C. Strict hand washing. Clients taking Methotrexate are more likely to get infections or may worsen any current infections. Therefore, hand washing will help to prevent the spread of infection.
Identify the correct sequence in how rheumatoid arthritis develops: A. Development of pannus, synovitis, ankylosis B. Anklyosis, development of pannus, synovitis C. Synovitis, development of pannus, anklyosis D. Synovitis, anklyosis, development of pannus
C. Synovitis, development of pannus, anklyosis
Mr. Mc Princeton who is diagnosed with rheumatoid arthritis (RA) complains about joints that always hurt, saying, "I just feel like staying in bed all day." Which discharge instruction would be aimed at maintaining as such function as possible? A. "Refrain from exercise because it only aggravates the disease process." B. "Apply elastic bandages to all joints to increase the pain threshold." C. "Maintain a supine position most of the day to prevent the stress of weight bearing." D. "Promote aquatic (water) exercises to enhance joint mobility."
D. "Promote aquatic (water) exercises to enhance joint mobility." Water exercises are excellent because water promotes buoyancy, which eases joint movement.
True or False: Rheumatoid arthritis tends to affect women more than men and people who are over the age of 60. True False
False
The nurse performs an assessment on a client newly diagnosed with rheumatoid arthritis. The nurse expects to note which early manifestations of the disease? Select all that apply Fatigue Anorexia Weakness Low-grade fever Joint deformities Joint inflammation
Fatigue Anorexia Weakness Low-grade fever Joint inflammation
Ibuprofen 400 mg orally four times daily has been prescribed for an older client with a diagnosis of rumor toward arthritis. The client asks the nurse about the amount of medication prescribed. The nurse response based on understanding what about this prescription dosage? It is the normal adult dose. It is lower than the normal adult dose. It is higher than the normal adult dose. It is an unusual dose for this diagnosis.
It is the normal adult dose. Rationale: for acute or chronic rheumatoid arthritis or osteoarthritis the normal oral adult dose for an older client is 200 to 800 mg 3 to 4 timesw daily.