A nurse is providing discharge planning for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis and starting methotrexate. What should the nurse include in the client's teaching?

Monitor for symptoms of anemia

Expect an increase in appetite while on the medication

Rotate the site of the patch application

Anticipate relief of symptoms in 1-2 weeks

Answer and Explanation

The Correct Answer is A

A. Monitoring for symptoms of anemia is essential as methotrexate can cause bone marrow suppression, leading to anemia. The nurse should instruct the client to report symptoms like fatigue, pallor, and shortness of breath.
B. Methotrexate is more likely to cause gastrointestinal side effects like nausea and loss of appetite rather than an increase in appetite.
C. Methotrexate is typically administered orally or by injection, not via a patch, so rotating the site of patch application is not relevant.
D. Relief of symptoms from methotrexate generally takes several weeks to months. It is important to set realistic expectations about the timeline for symptom improvement.

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Correct Answer is A

Explanation

A. The statement about keeping the temperature cold to avoid becoming overheated requires further teaching. While avoiding excessive heat is important for individuals with SLE, maintaining an overly cold environment can also trigger symptoms, as cold temperatures can lead to vasoconstriction and Raynaud's phenomenon, which is common in SLE patients.
B. Following the prescribed medication regimen and informing the healthcare provider of any side effects is an essential component of managing SLE. This indicates that the client understands the importance of medication adherence in controlling the disease.
C. Managing stress through relaxation techniques and therapy is appropriate, as stress is a known exacerbating factor for SLE. This statement reflects the client's understanding of the need to reduce stress to prevent flare-ups.
D. Wearing protective clothing when going outside is important because UV light exposure can trigger SLE exacerbations. This shows that the client is aware of the need to protect their skin from sunlight.

A. Administer desmopressin acetate 0.2 mg orally B. Maintain an intravenous (IV) infusion of 0.45% sodium chloride C. Restrict fluid intake to 1,000 mL per day D. Provide a diet containing 2 g of sodium per day

Correct Answer is C

Explanation

A. Desmopressin acetate is used to treat diabetes insipidus, not SIADH. In SIADH, there is excessive antidiuretic hormone causing fluid retention and dilutional hyponatremia, so this medication would not be appropriate.
B. Maintaining an IV infusion of 0.45% sodium chloride is not appropriate for SIADH, as this solution can further dilute sodium levels. Treatment usually involves hypertonic saline or fluid restriction.
C. Restricting fluid intake is a key management strategy for SIADH to address the fluid overload and help correct the low sodium levels. This action directly targets the root cause of the hyponatremia by reducing fluid intake.
D. Providing a diet with 2 g of sodium per day may not be sufficient or appropriate for treating SIADH-related hyponatremia. Fluid restriction is more critical in managing this condition.

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A nurse is providing discharge planning for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis and starting methotrexate. What should the nurse include in the client's teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a female client with systemic lupus erythematosus (SLE) about exacerbating factors for their disease. Which statement about exacerbating factors by the client requires further teaching?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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