A client is admitted to the hospital during an exacerbation of rheumatoid arthritis (RA). Which of the following nursing interventions are appropriate for a client experiencing an RA flare? (Select all that apply.)

Place client on total bedrest and avoid use of affected joints

Provide warm compresses to affected joints

Place several pillows under the head to keep the neck in a flexed position

Place the client on continuous cardiac monitoring

Administer methylprednisolone as ordered

Answer and Explanation

Correct Answer : B,E

A.   Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B.   Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C.   Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D.   Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E.   Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.

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Correct Answer is C

Explanation

A. Prednisone is a corticosteroid used to reduce inflammation and suppress the immune system. While effective for reducing inflammation and pain, corticosteroids are generally not the first-line treatment for osteoarthritis. They are more commonly used for inflammatory arthritis conditions like rheumatoid arthritis.
B. Etanercept is a biologic agent used to treat autoimmune conditions like rheumatoid arthritis and psoriatic arthritis by targeting tumor necrosis factor-alpha (TNF-alpha) to reduce inflammation. It is not indicated for osteoarthritis, which is a non-inflammatory degenerative joint disease rather than an autoimmune inflammatory disease.
C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to manage pain and inflammation associated with osteoarthritis. NSAIDs like ibuprofen are often the first-line treatment for osteoarthritis because they help reduce pain and inflammation, improve function, and enhance the quality of life for patients. Ibuprofen is a suitable and preferred option for managing symptoms of osteoarthritis.
D. Hydroxychloroquine is an antimalarial drug that is also used to treat autoimmune diseases such as rheumatoid arthritis and lupus. It works by modulating the immune system and reducing inflammation. However, it is not typically used for osteoarthritis, which is not an autoimmune condition.

A. Blood pressure of 132/60 mmHg and heart rate of 90 beats per minute B. Output to the Foley catheter has stopped C. The patient reports a pain level of 5/10 D. Pink-colored urine in the Foley collection bag

Correct Answer is B

Explanation

A. This blood pressure and heart rate are within normal ranges for most patients. For example, a blood pressure of 132/60 mmHg is slightly elevated on the systolic side but not critically so, and a heart rate of 90 beats per minute is within the normal range (60-100 beats per minute).
B. Continuous bladder irrigation is used to prevent clots and debris from obstructing the urinary tract after a TURP. If the output from the Foley catheter has stopped, it may indicate a blockage or clot in the catheter or bladder, which can lead to bladder distension, discomfort, and potential kidney damage.
Immediate reporting to the provider is crucial because this could indicate a severe complication.
C. Pain levels are subjective, and a pain level of 5/10 indicates moderate discomfort. While pain management is important, a pain level of 5/10 is not unusual after TURP, and it can often be managed with appropriate pain relief measures.
D. Pink-colored urine is not uncommon immediately following a TURP as a result of bleeding or irritation from the procedure. This finding can be expected and may not indicate an immediate complication.
However, if the urine color changes to bright red or if there is a significant increase in blood, it could be more concerning.

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A client is admitted to the hospital during an exacerbation of rheumatoid arthritis (RA). Which of the following nursing interventions are appropriate for a client experiencing an RA flare? (Select all that apply.)

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Explanation

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Explanation

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