A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching?
"Avoid napping during the day."<br>
"Avoid using ice packs when joints are inflamed."
"Take a hot shower to reduce pain in the morning."
"Decrease the amount of iron in your diet."
The Correct Answer is C
C. Heat therapy can help relax muscles and relieve stiffness in the joints, making it easier to move around and start the day.
A While it's important to maintain a regular sleep schedule, short naps may actually help manage fatigue associated with the condition
B. Cold therapy, such as using ice packs, can actually help reduce inflammation and relieve pain in inflamed joints for many individuals with RA.
D. Decreasing the amount of iron in the diet is not advisable without specific medical guidance.
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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
The client is at highest risk for wound infection as evidenced by the blood glucose level
Rationale
Type 2 diabetes mellitus: The client has poorly controlled diabetes with a preoperative Hemoglobin A1C of 9.5% and elevated glucose levels (280 mg/dL currently). Elevated blood glucose levels impair immune function and increase the risk of surgical site infections, including wound infections.
Postoperative state: After total knee arthroplasty, surgical wounds are vulnerable to infection. Hyperglycemia (high blood glucose levels) further increases susceptibility to infections due to impaired wound healing and compromised immune response.
Evidence: The client's current blood glucose level of 280 mg/dL (normal range 74 to 106 mg/dL) indicates poor glycemic control, which is a significant risk factor for developing wound infections postoperatively.
Correct Answer is C
Explanation
C. An increase in uric acid levels (hyperuricemia) is a hallmark finding in acute gout. Elevated uric acid levels predispose to the formation and deposition of urate crystals in joints, leading to the inflammatory response seen in gout attacks.
A While CK levels can increase in conditions affecting muscles (like rhabdomyolysis), it is not specifically associated with acute gout.
C Uric acid levels are typically elevated during acute gout attacks. This is because gout results from the deposition of urate crystals in the joints due to elevated serum uric acid levels. Therefore, during an acute gout attack, uric acid levels in the blood are often higher than normal.
D. Chloride is an electrolyte and its levels can vary based on hydration status, acid-base balance, and kidney function. It is not directly associated with acute gout, so its levels would not necessarily increase in this condition.
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