Wear & Tear
These three weight-bearing joints are most commonly and most painfully affected by osteoarthritis.
What are the spine, knees, and hips?
Unlike osteoarthritis, which is an inflammatory response disease, rheumatoid arthritis is classified as this type of disease in which the body attacks the it's own tissues.
What is an autoimmune disease?
This characteristic facial rash, named after an insect, appears across the cheeks and bridge of the nose in clients with SLE.
What is the butterfly (malar) rash?
This test, which measures how fast red blood cells settle in a tube, indicates inflammation in both RA and active lupus when elevated.
What is ESR (erythrocyte sedimentation rate)?
This is the maximum daily dose of acetaminophen in 24 hours, above which liver damage can occur — a critical teaching point for OA clients managing pain.
What is 4,000 mg in 24 hours?
This type of cartilage is damaged in osteoarthritis and is found at the surface where bones meet to form a joint.
What is articular cartilage?
In rheumatoid arthritis, the immune system specifically attacks this lining of the joint, causing inflammation and damage to surrounding tissue.
What is the synovium (synovial membrane)?
This is the most common type of lupus and the type that affects multiple organ systems including the kidneys, heart, and lungs.
What is systemic lupus erythematosus (SLE)?
This abbreviated blood test, an inflammation biomarker, is usually higher in clients with RA but can also be elevated in OA, obesity, and metabolic syndrome.
What is CRP (C-reactive protein)?
Before a client with RA starts an anti-TNF biologic such as Remicade, Enbrel, or Humira, the nurse must confirm screening for this infection, which can reactivate.
What is tuberculosis (TB)?
These bony outgrowths form from the friction of bone-on-bone contact as cartilage degenerates, causing irritation and inflammation in the surrounding tissue.
What are bone spurs (osteophytes)?
Females are 2 to 3 times more likely to develop RA than males, and it is more common in females who have never done this.
What is given birth?
Most clients with SLE are female, and most fall within this approximate age range.
What is 15 to 44 years old?
Because there is no definitive lab test for OA, diagnosis depends primarily on clinical presentation and this category of testing.
What is imaging (radiography, MRI, or ultrasound)?
A client with RA on long-term hydroxychloroquine reports new blurred vision. The nurse knows this organ is at risk and must report findings immediately.
What is the eye / retina (retinal damage)?
Because the root cause is cartilage damage, these two things are major risk factors.
What are injury and repetitive trauma?
These moveable subcutaneous lumps, ranging in size from a pea to a lemon, can form near pressure points or even internally in the lungs in severe cases of RA.
What are rheumatoid nodules?
This type of auto-immune disorder presents as a scaly, red rash on the face or scalp, though it can appear elsewhere. It can darken to brown over time, and sores may show up in the nose or mouth.
What is Discoid lupus erythematosus (DLE)
A strong positive of this autoantibody test suggests SLE, or the presence of other immune disorders, but is not definitive, since about 10% of people without lupus will also test positive.
What is ANA (antinuclear antibody)?
This communication method is considered best-practice to confirm that a client truly understands their medication instructions, especially important for complex RA and lupus regimens.
What is teach-back?
Although described as the most effective non-surgical and non-pharmaceutical treatment for osteoarthritis, many clients hesitate to do this for fear of causing more joint damage.
What is exercise (physical activity)?
RA clients should be monitored for may strongly correlated comorbid conditions, these two are the biggest risk.
What are heart disease and diabetes?
These three common environmental triggers, including this virus, this type of light, and this substance found in agriculture and industry, can all cause lupus flares.
What are Epstein-Barr virus, ultraviolet (UV) light, and silica dust?
When these two complement protein levels are LOW in a client with suspected lupus, it indicates this state of the disease.
What is active lupus (low C3 and C4 = active disease)?
A client with RA on prednisone for 6 months says she feels better and wants to stop her steroid today. The nurse teaches this critical safety principle and rationale about discontinuing corticosteroids.
What is they must be tapered, not stopped suddenly (to prevent a drop in blood pressure or blood glucose effects)?