Rheumatoid arthritis
A patient with RA complains of the daily exercise he has to go through. How should we explain how the exercise is helping his RA?
Movement. Which keeps joints from freezing.
"If you don't use it, you lose it"
Lupus is a multisystem autoimmune disease characterized by which autoantibodies?
Specifically, antinuclear antibodies (ANAs)
* The immune system makes antibodies to fight infection. In contrast, antinuclear antibodies often attack your body's own tissues — specifically targeting each cell's nucleus. In most cases, a positive ANA test indicates that your immune system has launched an autoimmune reaction.
This NSAID is recommended to be taken with food and is commonly prescribed for arthritis.
Ibuprofen.
Ball and socket, hinge, saddle, pivot and gliding are all examples of which type of joint articulation?
A. Synarthrosis
B. Diarthrosis
C. Amphiarthrosis
D. Articulatosis
B is correct. Diarthrosis (freely movable)
Synarthrosis (no movement)
Amphiarthrosis (allows limited movement)
Articulatosis is not correct.
The precursor to osteoporosis.
Osteopenia. Take the following precautions.
RA is an acute noninflammatory disease that affects some joints.
False: A chronic noninflammatory disease that affects all joints.
BONUS: How far does the average nurse walk in one shift?
5 km=3miles!
Acetaminophen is known to be primarily toxic to which organ?
Choose one: Liver, Kidney, Lungs, Heart.
The major target organ for nsaid's is the kidneys.
The student nurse is reviewing a patient's chart who has amyotrophic lateral sclerosis (ALS). The student would expect which of the following muscle responses.
A. Decrease in the size of the muscle due to disuse.
B. Contraction of the muscle due to muscle shortening.
C. Fluid-filled sacs around the joints due to disuse.
D. Lengthening of the muscles due to disuse.
A is correct. This is Atrophy a common symptom of ALS.
There are fasciculations of the muscles not contractions.
There are no fluid-filled sacs related to ALS.
The muscles shorten.
Female, Older Age, Small Frame, Family History of Disease, Asian or Caucasian Decent
Risk factors for OA
4 signs and symptoms you may see with a patient who has RA.
Muscle weakness, generalized weakness, joint swelling, fever, limited ROM, and subcutaneous nodules.
The nurse is working in a clinic and notices a patient with a butterfly skin rash. If suspicions are correct, the nurse will identify the most common risk factors. Select all that apply.
A. 69-year-old biological male.
B. A 22-year-old biological female.
C. Of Eastern European descent.
D. Of Latin American descent.
E. Genetic predisposition.
F. History of Sjogren’s syndrome.
This corticosteroid is given via injection and is used to treat inflammation of a joint, tendon, or bursa.
What is a cortisone injection.
Which of the following is correct?
A. Epiphysis is a bone-forming cell.
B. Osteoblasts are bone-forming cells.
C. Osteocytes are bone-forming cells.
D. Osteoclasts are bone-forming cells.
B is correct. Osteoblast is the bone-forming cell.
Epiphysis is the end of a long bone.
Osteocytes-mature bone cells that maintain the bone function.
Osteoclasts- function in the destruction and reabsorption of old bone.
What findings can be ID by an x-ray of the spine?
A. Dislocations, infections, fractures, OA
B. Fractures, dislocations, soft tissue lesions, OA
C. Fractures, infections, spinal root disorders, OA
D. Dislocations, fractures, OA and bone marrow abnormalities.
A is correct.
Soft tissue lesions-CT
Spinal root disorders-EMG
Bone Marrow abnormalities-Bone scan/labs.
A patient is suspected of having rheumatoid arthritis. The diagnostic regimen includes aspiration of synovial fluid from the knee for a definitive diagnosis. The nurse knows one of the following procedures is necessary for the diagnosis.
A) Angiography
B) Myelography
C) Paracentesis
D) Arthrocentesis
D. Arthrocentesis is the aspiration of synovial fluid.
*Angiography is the examination by X-ray of blood or lymph vessels, carried out after the introduction of a radiopaque substance.
*Myelography uses contrast material and X-rays or (CT) scans to get detailed pictures of your spine.
*Paracentesis a procedure in which a needle or catheter is inserted into the peritoneal cavity to obtain/drain ascitic fluid.
A nurse is providing education to a client with SLE about ways to prevent flare-ups. Which statement below indicates a need for further client teaching?
a.) “I will continue to get my influenza vaccine yearly”
b.) “When I go outside, I need to make sure to cover up my skin with clothes or wear sunscreen greater than 55 SPF.”
c.) “It is best to avoid physical exercise because it can cause stress on the body and cause a flare-up.
D. “My diet should consume low-fat, high-fiber, and low-salt foods”
C. Incorrect-It is important to keep joints moving.
A patient with a history of chronic back due to arthritis is admitted to the hospital with a vertebral compression fracture. The physician orders a “now” dose of codeine 45 mg IM for the patient’s pain. You have on hand codeine 60 mg/2 mL. How many milliliters should the nurse administer to the patient?
1.5 ml.
60:2::45:x
45x2=90
90/60=1.5ml
The nurse is preparing the patient to be transferred for an MRI. The nurse performs the following intervention:
A. Ensures the patient does not have credit cards in the pocket as the MRI can erase the magnetic strips.
B. Nonremovable cochlear implants may become inoperable.
C. Apply gauze over the transdermal patch as it cannot be removed due to alteration of the absorption rate.
D. Remove jewelry as it may interfere with the operation of the MRI
C is correct. This is a false statement. The nurse must remove the transdermal patch, or the patient may sustain a burn. Remember, transdermal patches have a thin layer of aluminum.
No cure, Replacement Surgery, Medications, Physical Therapy, and Occupational therapy.
A. Osteoarthritis
B. Osteopenia
C. Osteoporosis
D. Osteomyelitis
Treatment for OA.
Osteopenia is keeping active, getting enough calcium and vit D, and a healthy diet.
Osteoporosis Bisphosphonates. Include Alendronate (Fosamax) weekly. Risedronate (Actonel), weekly or monthly.
Identify 2 nursing interventions we can do for a patient with RA.
Encourage doing ADLs independently as much as possible, the use of splints, low weight bearing exercises, provided education about disease progression.
The nurse knows that the characteristics of SLE include which of the following? Select all that apply.
A. Temperature < 98.6
B. Butterfly rash
C. Damage to the dura of the brain.
D. Damage to the kidneys.
E. Joint inflammation
F. Damage to the liver.
Characteristics of SLE:
remissions and exacerbations; fever; skin rash; joint inflammation; and damage to the kidney, lungs, and serosal membranes (lines body cavities).
A patient with lupus in remission is admitted to the emergency department with severe dehydration which can exacerbate lupus. The NP orders 2,000 mL of normal saline to be infused over the next 4 hours. The IV tubing has a drop factor of 15. How many milliliters per hour will you set on a controller?
The answer is 500ml/hr.
2000/60x15=500ml/hr.
Total volume (in mL). Divided by 1 hour in time (in min) Multiplied by the drop factor (in gtts/mL)
The nurse is providing discharge instructions to an adult patient who fractured their arm. The nurse calculates the daily dose of Ibuprofen and instructs the patient to take no more than 2 tablets of 400 mg every 2-4 hours. Is this an appropriate dose?
No. This is not the correct dose. Ibuprofen adult daily maximum dose is 3200mg/24 hours. (Unless directed by a health care provider.) Correct is 200-400mg every 4-6 hours.
Q2h=4800mg
Q4=ok at 2400mg but she told the patient to take them Q2-4.
Tinel sign, nerve conduction studies, tingling, pain, numbness, and weakness. Are all signs of which condition?
A. OA (osteoarthritis)
B. RA (rheumatoid arthritis)
C. CTS (carpal tunnel syndrome)
D. Gout
C is correct.