chapter 64 med surge
The patient has a painful hematuria.
The patient with dermatomyositis is receiving long-term prednisone therapy. Which assessment finding by the nurse is important to report to the health care provider?
C-reactive protein
Which laboratory result will the nurse monitor to determine if prednisone has been effective for a patient with an acute exacerbation of RA?
Document the patient's oral intake.
Which nursing action can the RN delegate to the UAP who are assisting with the care of a patient with scleroderma?
A 56-yr-old woman who works on an automotive assembly line.
Which patient seen by the nurse in the outpatient clinic is most likely to require teaching about ways to reduce the risk for OA
Elevated blood Urea nitrogen (BUN)
Which result for a patient with systemic lupus erythematosus is most important for the nurse to communicate to the health care provider?
"I will use sunscreen when I am outside."
Which statement by a patient with systemic lupus erythematosus indicates the patient has understood the nurse's teaching about the condition?
"tell me more about the situations that are causing you stress."
A patient with two school -age children has recently been diagnosed with RA and tells the nurse that home life is very stressful. Which initial response by the nurse is most appropriate?
Social isolation.
A 25yr-old female patient with Lupus who has a facial rash and alopecia tells the nurse, "I never leave my house because I hate the way I look," The nurse will plan interventions with the patient to address the nursing diagnosis of
the patient is trying to get pregnant before her disease becomes more severe.
A 29-yr-old woman is taking methotrexate to treat RA. Which information from the patient's health history is important for the nurse to report to the health care provider related to methotrexate?
Anti-Smith antibody(Anti-SM)
A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus. Which test will provide the most specific finding for the nurse to review?
Assess the nodules for a skin breakdown or infection.
A patient being seen in the clinic has rheumatoid nodules on the elbow. Which action will the nurse take?
Keep the environment warm and draft free.
A patient has scleroderma manifested by CREST syndrome. Which action will the nurse include in the plan of care?
is sexually active with multiple partners.
A patient hospitalized with fever and red, hot, painful n knees is suspected of having septic arthritis. Information obtained during the nursing history that indicates a risk factor for septic arthritis is that the patient.
risk for aspiration.
A patient hospitalized with polymyositis has joint pain; eyelid edema; and a weak, hoarse voice. The safety priority for the patient is addressing the
doxycycline (Vibramycin)
A patient reporting painful urination and knee pain is diagnosed with reactive arthritis. The nurse will plan to teach the patient about the need for several months of therapy with
The blood pressure is 86/50mm Hg,
A patient who had arthroscopic surgery of the right knee 7 days age is admitted with red, swollen, hot knee. Which assessment finding by the nurse should be reported to the health care provider immediately
sertraline (Zoloft)
A patient who takes multiple medications develops acute gouty arthritis. The nurse will consult with the health care provider before giving the prescribed dose of
Suggest the patient use over-the-counter (OTC) artificial tears.
A patient with (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is Appropriate?
The patient takes one aspirin a day to prevent angina.
A patient with an acute attack of gout in the right great toe has a new prescription for probenecid. Which information about the patient's home routine indicates a need for teaching regarding gout management?
blood pressure
A patient with gout has a new prescription for losartan to control the condition. The nurse will plan to monitor
Crackles are auscultated in the lung base.
A patient with psoriatic arthritis and back pain is receiving etanercept(Enbrel). Which finding is most important for the nurse to report to the health care provider?
"I will taken 1g of Tylenol) every 4 hours"
After the nurse has finished teaching a patient with osteoarthritis (OA) of the right hip about how to manage the OA, which patient statement indicates a need for more teaching?
"I will need to stop drinking so much coffee and soda."
After the nurse has taught a 28-yr-old with fibromyalgia, which statement by the patient indicates a good understanding of effective self-management?
self-administration of subcutaneous injection.
Anakinra is prescribed for a patient with RA. when teaching the patient about this drug, the nurse will include information about
A. sleep disturbances B. multiple tender points E widespread bilateral, burning musculoskeletal pain
During assessment of the patient with fibromyalgia, the nurse would expect the patient to report which of the fallowing MM
Administer varicella vaccine
The health care provider has prescribed the following interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question?
The patient sleeps with two pillows under the head.
The home health nurse is making a follow-up visit to a patient with recently diagnosed RA. which assessment made by the nurse indicates more patient teaching is needed?
Laboratory results indicate blood urea nitrogen is elevated.
The nurse assesses a 78-yr-old who uses naproxen (Aleve) daily for hand and knee OA management. Which information requires a discussion with the health care provider about an urgent change in the treatment plan?.
"I should lie down for an hour after each meal."
The nurse determines additional instruction is needed when a patient diagnosed with scleroderma makes which statement?
reduced joint pain.
The nurse determines that colchicine has been effective for a patient with acute attack of gout upon finding
Use a footboard to hold bedding away from the toe.
The nurse is planning for a patient with hypertension and gout who has a red, painful right great toe. Which nursing action will be included in the plan of care?
Ask the patient about recent outdoor activities.
The nurse notices a circular lesion with a red border and clear center on the arm of a summer camp counselor who is in the cli9nic complaining of chills and muscle aches. Which action should the nurse take to follow up on that finding?
A warm bath fallowed by a short rest.
The nurse suggests that a patient recently diagnosed with RA plan to start each day with
avoid activities requiring repetitive use of the same muscles and joints.
The nurse teaching a support group of women with RA about how to manage activities of daily living suggested they should
capsaicin cream (Zostrix)
The nurse will anticipate the need to teach a patient who has osteoarthritis (OA) about which medication?
D swan neck
When reviewing a the health record for a new patient with RA, the nurse reads that the patient has swan neck deformities.
" It is important to start methotrexate early to decrease the extent of joint damage"
When the nurse brings medication to a patient with RA, the patient refuses the prescribed methotrexate. The patient tells the nurse," My arthritis isn't that bad yet. The side effects of methotrexate are worse than the arthritis." The most appropriate response by the nurse is
Encourage the patient to take a nap in the afternoon.
Which action will the nurse include in the plan of care for a patient with a new diagnosis of (RA)?
Advise the patient to sleep on the back with a flat pillow.
Which action will the nurse include in the plan of care for a patient with a newly diagnosed ankylosing spondylitis?
the patient has dark-colored stools.
Which assessment finding for a patient using naproxen (Naprosyn) to treat osteoarthritis is likely to required a change in medication.
The patient's blood glucose is 165mg/dl.
Which assessment information obtained by the nurse indicates a patient with an exacerbation of RA is experiencing a side effect of prednisone?
Blurred vision
Which finding for a patient who is taking hydroxychloroquine (Plaquenil) to treat RA is likely to be an adverse effect of the medication?
Discomfort with joint movement.
Which finding will the nurse expect when assessing a patient who has osteoarthritis (OA) of the knee?
Applying cold packs before exercise may decrease joint pain.
Which information will the nurse include when preparing teaching materials for a patient with an exacerbation of RA?
A gradual increase in daily exercise may help decrease fatigue.
Which information will the nurse include when teaching a patient with newly diagnosed systemic exertion intolerance disease about self-management?
Do daily deep-breathing exercises.
Which information will the nurse include when teaching patient with a newly diagnosed ankylosing spondylitis about managing of the condition?
The WBC's count is 1500/uL.
Which laboratory result is important to communicate to the health care provider for a patient who is taking methotrexate to treat RA?
