rheumatoid arthritis
rheumatoid arthritis
-autoimmune disorder where white blood cells attack the synovial tissue.
2 infection and pancytopenia are adverse effects of etanercept. laboratory studies are performed prior to and during medication treatment. the appearance of abnormal white blood cell counts and abnormal platelet counts can alert the nurse to a potentially life-threatening infection. injection site itching is a common occurrence following administration. a metallic taste and loss of appetite are not common signs of adverse effects of this medication.
a client has been on treatment for rheumatoid arthritis for 3 weeks. during the administration of etanercept, which is most important for the nurse to assess? 1) the injection site for itching and edema 2) the white blood cell counts and platelet counts 3) whether the client is experiencing fatigue and joint pain 4) whether the client is experiencing a metallic taste in the mouth and a loss of appetite
b, d, e ESR is a laboratory test used to diagnose RA. this laboratory test will show an elevated result in clients who have RA. ANA is a laboratory test used to diagnose RA. this laboratory test will show a positive result in clients who have RA. WBC count is a laboratory test used to diagnose RA. this laboratory test will show a decreased result in clients who have RA.
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 c) BUN d) antinuclear antibody titer e) WBC count
a include in the teaching that the client who has RA can experience stiffness in the joints upon rising.
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? a) "you can experience morning stiffness when you get out of bed." b) "you can experience abdominal pain." c) "you can experience weight gain." d) "you can experience low blood sugar."
1, 2, 3, 4 because emotional stress frequently exacerbates the symptoms of rheumatoid arthritis, the absence of symptoms is a positive finding. DMARDs are given to slow the progression of joint degeneration. in addition, an improvement in the range of motion after 3 months of therapy with normal blood work is a positive findings. temperature elevation and inflammation and irritation at the medication injection site could indicate signs of infection.
in monitoring a client's response to disease-modifying antirheumatic drugs, which assessment findings would the nurse consider acceptable responses? select all that apply. 1) control of symptoms during periods of emotional stress 2) normal white blood cell, platelet, and neutrophil counts 3) radiological findings that show no progression of joint degeneration 4) an increased range of motion in the affected joints 3 months into therapy 5) inflammation and irritation at the injection site 3 days after the injection is given 6) a low-grade temperature on rising in the morning that remains throughout the day
therapeutic procedures
-plasmapheresis -total joint arthroplasty -synovectomy -total joint arthroplasty if unresponsive to medication
medications
-NSAIDs -corticosteroids -disease modifying anti-rheumatic drugs (methotrexate, leflunomide, hydroxychloroquine) -biologic-response modifiers (etanercept, adalimumab)
assessment
-pain at rest and with movement -morning stiffness -subcutaneous nodules -joint pain & joint swelling -lack of function
complications
-sjogren's syndrome- a disorder of your immune system identified by its two most common symptoms- dry eyes and a dry mouth. -secondary osteoporosis -vasculitis- involves inflammation of the blood vessels. the inflammation can cause the walls of the blood vessels to thicken, which reduces the width of the passageway through the vessel. if blood flow is restricted, it can result in organ and tissue damage. -respiratory complications- lung tissue complications -cardiac complications- inflammatory process can affect cardiac tissue
joint deformity
-ulnar deviation -swan neck -boutonniere deformities
a, b, e exacerbating factors, such as a recent illness like influenza; a decrease in range of motion; and pain at rest are indicative of RA.
a nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis. 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
