A nurse is caring for a client on an orthopedic unit. The client is experiencing joint discomfort and stiffness, particularly in the morning. The healthcare team is monitoring the client closely for any changes in mobility or overall well-being.
Complete the diagram by dragging from the choices below to specify 1 potential condition the client is most likely experiencing, 2 actions the nurse would take to address that condition, and 2 parameters the nurse would monitor to assess the client's progress.
The Correct Answer is []
Rationale:
The client’s symptoms of morning stiffness, symmetrical joint involvement (hands and knees), swelling of proximal interphalangeal joints, and elevated ESR and CRP with a positive rheumatoid factor are characteristic of rheumatoid arthritis. This autoimmune condition causes chronic inflammation of synovial joints, leading to pain, stiffness, and decreased function.
Encouraging range of motion exercises helps maintain joint flexibility, prevent contractures, and improve mobility in clients with rheumatoid arthritis. Administering anti-inflammatory medications reduces joint inflammation, alleviates pain, and slows disease progression.
Monitoring pain level provides insight into the effectiveness of treatment and the client’s functional status. Assessing joint swelling helps evaluate the degree of inflammation and progression or improvement of the disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Rationale:
A. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can inhibit platelet function and increase bleeding risk. In children with hemophilia, NSAIDs should be avoided for pain management. Acetaminophen is preferred for mild to moderate pain.
B. Monitoring vital signs helps detect early signs of internal bleeding, such as tachycardia or hypotension. Observing the progression of bruising and joint swelling is essential to assess bleeding severity and prevent complications like hemarthrosis or joint damage.
C. Children with hemophilia are at high risk for bleeding with trauma or falls. Activity should be encouraged with appropriate protective gear, supervision, and avoidance of high-impact sports to prevent injuries.
D. Administration of the specific clotting factor (Factor VIII or IX, depending on type) is the primary treatment for preventing or controlling bleeding episodes in hemophilia. Early replacement can reduce joint damage and manage pain associated with hemarthrosis.
Correct Answer is C
Explanation
Rationale:
A. Gastrointestinal distress caused by NSAIDs like ketorolac is primarily due to gastric mucosal irritation, not potassium deficiency. A diet high in potassium does not prevent NSAID-related GI complications. Protective strategies include taking the medication with food or using gastroprotective agents if needed.
B. Ketorolac is a potent NSAID with a high risk of renal toxicity, gastrointestinal bleeding, and cardiovascular effects. It is generally not recommended for long-term or repeated use, and overlapping NSAIDs can increase the risk of adverse effects. The nurse should avoid concurrent NSAIDs unless explicitly prescribed.
C. Ketorolac can cause acute kidney injury, fluid retention, and electrolyte imbalances, even in patients without prior renal issues. Monitoring serum creatinine, BUN, and intake/output is essential to detect early renal compromise. This is especially important in patients with rheumatoid arthritis who may already be at risk due to chronic inflammation or other medications.
D. Taking ketorolac on an empty stomach increases the risk of gastric irritation and ulcers. NSAIDs should typically be taken with food or milk to minimize gastrointestinal adverse effects.
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