*NURSING > STUDY GUIDE > NR 603 Week 7 Quiz Graded A - Chamberlain College (All)
RA OA Identifying factors Autoimmune disorder more common with women causes inflammation in synovium Morning stiffness grater than 30 min Swan neck of DIP and PIP Fatigue Fever... Anemia Degenerative disk dieses. Cartilage over the join surfaces is damaged Morning stiffness less than 30 min (short duration of pain) Joints swollen and tender Heberden’s nodes- nodules on distal finger joints Bouchard’s- nodules on proximal joints First line treatment 1. NSAIDS 2. Steroids oral then injection 3. Antirheumatic drugs 4. Anti TNF (due not give if immune system is down) Refer to rheumatologist 5. Acetaminophen 325-650mg 4-6 hrs. 6. Short acting NSAID’s if no refile from Tylenol 7. Use PPI for GI protection 8. Can use topical NSAIDS capsaicin cream Stop smoking, weight bearing exercises, heat or ice What do you monitor during treatment Sed rate CBC (mild microcytic and normocytic anemia) RF factor: X-ray (show bony erosion, joint space narrowing, subluxation) Negative labs and findings What’s effected Hands wrist, elbows, ankles, feet and shoulder “sausage joints” Large weight bearing bones (hips knees spines Unilateral vs bilateral Bilateral Unilateral Polymyalgia Rheumatica Temporal Arteritis (giant cell) Identifying factors Bilateral join stiffness in shoulders neck, hips, and torsos Can quickly develop GCA Acute temporal headache with temporal arteries inflamed. Inflammatory disorder of medium and large arteries of body Scalp tenderness and along temple Temporal artery warm tender and feels cord like Pain with chewing Vision impairment to one side This study source was downloaded by 100000831988016 from CourseHero.com on 05-07-2022 04:50:33 GMT -05:00 https://www.coursehero.com/file/41064380/week-7-quizdocx/ First line treatment Oral steroids 1. High dose steroids n 40-60 mg 2. Optho or ED 3. Temporal artery biopsy gold standard What do you monitor during treatment Sed rate CRP Sed rate > 100 mm/hr CRP will be elevated What’s effected Shoulder, hips, torso, neck Temporal arties on one side Can feel pain in scalp and pain in jaw with chewing Unilateral vs bilateral Bilateral stiffness lasting longer than 30 min Unilateral headache Systemic lupus Erythematous Identifying factors Multisystem autoimmune disease affecting women Remission and exacerbation Rash butterfly shape face First line treatment Topical and oral steroids Plaquenil Methotrexate Biologics Refer to rheumatologist What do you monitor during treatment UA positive for proteinuria What’s effected Skin, kidneys, heart, and blood vessels Avoid sun Cover skin with clothes and hats Use SPF cccc [Show More]
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