Allergies
Client complains of allergic rhinitis. What is an important assessment question to ask?
Which OTC meds have u taken?
Client with RA has nontender, movable nodules in the SubQ tissue over the elbows and shoulders. Which statement is the scientific rationale for the nodules?
the nodules indicate a rapidly progressive destruction of the affected tissue.
What lab test is ordered if SLE is suspected?
CBC and antibody tests.
Clients usually present with moderate to severe anemia, thrombocytopenia, leukopenia and a positive antinuclear antibody. No definitive test to Dx SLE.
In the rheumatologists office, what task can a RN delegate to an LPN?
demonstrate how to use clothing equipped with Velcro fasteners.
Which problem is a priority for a client diagnosed with RA?
alteration in comfort.... Why?
Client is highly allergic to insect venom, they were prescribed insect venom. What is the rationale?
Prevents anaphylaxis following a future sting (creates passive immunity)
RA client prescribed etanercept (tumor necrosis factor alpha inhibitor) shows marked improvement. What should nurse teach regarding use of medication.
Continue to have checkups and lab work while taking meds.
What is an assessment finding that can support SLE?
pericardial friction rub and crackles in the lungs
Nurse on medical unit has received morning report. Which client should the nurse assess first.
Client who has received initial dose of IV ABX at 0645. Why? Let's discuss.
What are shared S&S of RA and SLE?
joint stiffness and pain
Client has red, raised rash covering forearms, neck, and face and experiencing extreme itching. Allergic reaction to poison ivy. What discharge instructions should the nurse teach?
Explain how to take a steroid dose pack.
Which assessment findings in an RA client warrant immediate intervention?
crying, flat facial affect, and refuses to speak to nurse. Why? (let's discuss)
When building a care plan for a patient with SLE, what goal is a priority?
No deterioration of organ function
Client Dx with pneumocystis pneumonia. Which of the HCP's orders should the nurse implement first?
administer O2 via NC
For a client diagnosed with TB what statement indicates understanding of discharge instructions?
I must stay on medication for months if I am to get well.
Pt may be on medications for 6 months to 1 year.
Client stung by bee is being discharged from ED. What priority discharge instruction should be taught?
Demonstrate how to use an Epi pen. Life saving education
What preventative care should nurse include with RA clients regularly scheduled clinic visits.
Recommend flu and pneumonia vaccines
What are educational points to give a patient newly diagnosed with SLE? (3 parts)
1) SPF > or equal to 30 when in sunlight
2) Notify HCP immediately when developing a low grade fever
3) hands and feet may change color when exposed to hot or cold
Nurse is assessing a client with cutaneous lupus erythematosus. Which intervention should be inplemented?
Dry the skin thoroughly by patting
These S&S indicate which condition?
decreased mobility, autoimmune reaction, originates in synovial fluid, causes formation of panes.
Rheumatoid Arthritis
Client in ED has severe anaphylactic reaction after penicillin IV dose. Which interventions should the nurse implement? (4 parts)
1) administer Solu-Medrol IV
2) Initiate rapid response team
3) administer epinephrine SQ, then IV continuous
4) assess pts pulse and respirations
Nurse is planning the care for a client diagnosed with RA. Which intervention should be implemented?
Obtain an order for a sedative. Why?
Client Dx with acute exacerbation of SLE is prescribed high-dose steroids. What is the scientific rationale for using high-dose steroids in treating SLE?
Steroids will suppress tissue inflammation, which will reduce damage to organs.
Patient presents to ED with wheezing, dyspnea, cannot speak and are blue around the mouth after coming into contact with an allergy, what intervention should the nurse prepare to do?
Administer O2 at 100
Patient asks what time of year does allergic rhinitis occur? What is the best response from the nurse?
Allergic rhinitis is least likely to occur in the winter.