Nokea
Which of the following actions should the nurse implement for a patient with septic arthritis?
- A. Hot compress on affected area tid
- B. Active ROM exercises qid
- C. Monitor BP q4h
- D. Passive ROM exercises bid
Correct Answer: A
Rationale: Local hot compresses can also help relieve pain associated with septic arthritis. Only gentle ROM exercises are advocated. The temperature should be monitored often but the BP does not need to be assessed q4h.
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The nurse is caring for a patient who has systemic sclerosis manifested by CREST (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia) syndrome. Which of the following actions should the nurse include in the plan of care?
- A. Avoid use of capsaicin cream on hands.
- B. Keep patient's room warm and draft free.
- C. Obtain capillary blood glucose before meals.
- D. Assist to bathroom every 2 hours while awake.
Correct Answer: B
Rationale: Keeping the room warm will decrease the incidence of Raynaud's phenomenon, one aspect of the CREST syndrome. Capsaicin cream may be used to improve circulation and decrease pain. There is no need to obtain blood glucose levels or to assist the patient to the bathroom every 2 hours.
The nurse is teaching a patient with osteoarthritis (OA) of the left hip and knee about management of OA. Which of the following patient statements indicate a need for further education?
- A. I can take glucosamine to help decrease my knee pain.
- B. I will take 1 g of acetaminophen every 4 hours.
- C. I will take a shower in the morning to help relieve stiffness.
- D. I can use a cane to decrease the pressure and pain in my hip.
Correct Answer: B
Rationale: No more than 4 g of acetaminophen should be taken daily to avoid liver toxicity. The other patient statements are correct and indicate good understanding of OA management.
The nurse is caring for a patient in a long-term care facility who takes multiple medications and has developed acute gouty arthritis. Which of the following medications should not be given until the health care provider has been consulted?
- A. Serratiopeptidase
- B. Famotidine
- C. Oxycodone
- D. Hydrochlorothiazide
Correct Answer: D
Rationale: Diuretic use increases uric acid levels and can precipitate gout attacks. The other medications are safe to administer.
The nurse is caring for a patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia who tells the nurse, 'I hate the way I look! I never go anywhere except here to the health clinic.' Which of the following is an appropriate nursing diagnosis for the patient?
- A. Activity intolerance related to immobility
- B. Impaired social interaction related to insufficient knowledge about how to enhance mutuality
- C. Impaired skin integrity related to excretions
- D. Social isolation related to difficulty establishing relationships (embarrassment about the effects of SLE)
Correct Answer: D
Rationale: The patient's statement about not going anywhere because they hate the way they look supports the diagnosis of social isolation because of embarrassment about the effects of the SLE. Activity intolerance is a possible problem for patients with SLE, but the information about this patient does not support this as a diagnosis. The rash with SLE is nonpruritic. There is no evidence of lack of social skills for this patient.
The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine for systemic lupus erythematosus. Which of the following orders should the nurse question?
- A. Draw anti-DNA blood titre.
- B. Administer varicella vaccine.
- C. Use naproxen 200 mg BID.
- D. Take famotidine 20 mg daily.
Correct Answer: B
Rationale: Live virus vaccines, such as varicella, are contraindicated in a patient taking immunosuppressive drugs. The other orders are appropriate for the patient.