Chapter 39
What should the nurse teach the patient about the diagnosis of osteoarthritis?
"It is the most common and frequently disabling of joint disorders."
The nurse is teaching a patient about her rheumatic disease. What statement best helps to explain "autoimmunity?"
"Your symptoms are a result of your body attacking itself."
The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins.
Colchicine - Colchicine, along with indomethacin, ibuprofen, or a corticosteroid is prescribed to relieve an acute attack of gout. Benemid and Anturane increase the urinary excretion of uric acid, and Aloprim breaks down purines before uric acid is formed.
The side effect of bone marrow depression may occur with which medication used to treat gout?
allopurinol (Zyloprim)
What is the priority intervention for a patient who has been admitted repeatedly with attacks of gout?
assess dietary diet and activity at home
The nurse is performing discharge teaching for a patient with rheumatoid arthritis. What teachings are priorities for the patient?
assistive devices, safe exercise, medication dosages and side effects
The nurse intervenes to assist the patient with fibromyalgia to cope with what symptoms?
chronic fatigue, generalized muscle aching, and stiffness
Which of the following would be consistent with the diagnosis of rheumatoid arthritis?
cloudy synovial fluid
Which of the following is an appropriate nursing intervention in the care of the patient with osteoarthritis?
encourage weight loss and an increase in aerobic activity
Which of the following is an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
tophi
The nurse is caring for a patient who is being treated for fibromyalgia. What intervention will best assist the patient to restore normal sleep patterns?
tricyclic antidepressants
Which of the following newer pharmacological therapies, used for treatment of osteoarthritis, is thought to improve cartilage function and retard degradation as well as have some anti-inflammatory effects?
vicosupplementation
A nurse should advise a patient with gout to avoid which of the following foods?
Organ meats and scallops- An excessive intake of foods that are high in purines (shellfish, organ meats) may result in symptoms of gout in susceptible persons. A diet low in purine is recommended.
The nurse is constructing a teaching plan for the client newly diagnosed with scleroderma. Which of the following should the nurse include in the teaching plan?
Protect the hands and feet from cold. Explanation: Raynaud's phenomenon is associated with scleroderma. Client teaching must include strategies for protecting the feet and hands.
The nurse is caring for a patient who has been diagnosed with "rheumatic disease." What nursing diagnosis will most likely apply to this patient's care?
fluid and electrolyte imbalance, alteration in self-concept, fatigue, pain
The nurse teaches the patient that the presence of crystals in his or her synovial fluid obtained from an arthrocentesis confirms which disease process?
gout
Scleroderma typically begins with which system involvement?
integumentary
Which of the following points should be included in the medication-teaching plan for a patient taking adalimumab (Humira)?
it is important to monitor for injection site reactions
Which of the following is the most common joint affected in gout?
metatarsophalangeal
A patient with rheumatoid arthritis is complaining of joint pain. What intervention is a priority to assist the patient?
nonsteroidal anti-inflammatory drugs (NSAIDs)
Which of the following is the leading cause of disability and pain in the elderly?
osteoarthritis
Nursing care for the patient with fibromyalgia should be guided by what assumption?
patients with fibromyalgia may feel as if their symptoms are not taken seriously
What intervention is a priority for a patient diagnosed with osteoarthritis?
physical therapy and exercise
A patient is admitted with an acute attack of gout. What interventions are essential to this patient?
probenecid (Benemid), serum uric acid level, corticosteroid therapy, pain medications
Which diagnostic study finding is decreased in patients diagnosed with rheumatoid arthritis?
red blood cell count
Which of the following connective tissue disorders is characterized by insoluble collagen being formed and accumulating excessively in the tissues?
scleroderma
Which of the following disorders is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks?
systemic lupus erythematous (SLE)
What intervention will best help the patient with ankylosing spondylitis (AS)?
teach the patient to use a walker or cane
