467: Autoimmune
Osteoarthritis is known as a disease that is
the most common and frequently disabling of joint disorders
A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?
Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.
Which is an appropriate nursing intervention in the care of the client with osteoarthritis?
Encourage weight loss and an increase in aerobic activity
A client is seen in the office for reports of joint pain, swelling, and a low-grade fever. What blood studies does the nurse know are consistent with a positive diagnosis of rheumatoid arthritis (RA)? Select all that apply.
Positive C-reactive protein (CRP) Positive antinuclear antibody (ANA) Red blood cell (RBC) count of <4.0 million/mcL
Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
Scleroderma
The nurse is assessing a client who has had rheumatoid arthritis for several years. What clinical manifestation will the nurse expect to find in a client?
Small joint involvement
Which term refers to fixation or immobility of a joint?
Ankylosis
Which of the following procedures involves a surgical fusion of the joint?
Arthrodesis
As part of the assessment process for a client suspected of having gout, the nurse evaluated the client's serum uric acid levels. Select the value that is considered above the saturation point for crystal formation.
6.8 mg/dL
A client with a history of peptic ulcer disease is diagnosed with rheumatoid arthritis. What medication will the nurse anticipate will be prescribed to produce an anti-inflammatory effect and protect the stomach lining?
Celecoxib
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
The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider?
Colchicine
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 client diagnosed with degenerative joint disease of the fingers reports now having bumps on the fingers that do not hurt. The nurse observes bony nodules on the distal interphalangeal joints. What type of "bumps" does the nurse understand these are?
Heberden nodes
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement?
Hypertension
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
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 kyphosis caused by ankylosing spondylitis (AS) asks if there are any procedures available to help with the spinal deformity and pain. Which procedure will the nurse prepare teaching for this client?
Osteotomy of the spine
The nurse is caring for a client with palindromic rheumatism. The nurse knows that this type of rheumatism can lead to which diagnosis?
RA
A client is diagnosed with systemic lupus erythematosus (SLE). Which of the following would be most appropriate for the nurse to use to evaluate the client' s stage of disease?
Review the client's medical record
Which of the following disorders is characterized by an increased autoantibody production?
SLE
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
The nurse is working with a client with systemic lupus erythematosus (SLE). What are the immune abnormalities characterized by SLE? Select all that apply.
Susceptibility abnormal innate and adaptive immune responses autoantibodies immune complexes Inflammation damage
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
Tophi
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.
An older adult with rheumatoid arthritis says exercise was not effective. Which response will the nurse make to learn the reason for the failure of this treatment approach?
What types of exercises were you doing?
