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Question: def of Answer: a chronic, systemic inflammatory disorder that primarily affects the Question: does is women more then men or men more then women Answer: women more then Question: at what age does it develop Answer: age 30 -50 Question: it has periods of remission followed by ________Answer: Question: it is an autoimmune disorder, what is the Answer: Question: what do the T (tcells) do?Answer: they migrate to the and infiltrate the synovial membrane, causing an immune resonse Question: what is produced when the response is initiated Answer: IgG Question: what does the body see as a substance; what does it make inresponse to the foreign substance Answer: the IgG ; IgG immunoglobulin autoantibodies (aka rheumatoid factor) Question: the rheumatoid bind with what to form immune complexes Answer: the Question: Because of this WBCs are to the area; what do the WBCs do to the joint tissueAnswer: they enzymes that distroy the joint tissue Question: the of joint tissue causes what Answer: inflammation Question: what are s/s of inflames Answer: they are red and painful Question: what is Answer: vascular tissue (new blood vessels), in the synovial membrane- it destroys joint tissue Question: is RA Answer: Yes - it other tissues along with joint Question: s/s Answer: anorexia, weight loss, and nonspecific aching and sitffness, , anemia, low grade fever, rheumatoid nodules Question: do manifestations develop slowly or fastly Answer: slowly Question: s/s of involvement Answer: swelling, stiffness, warmth, tenderness, pain, limited ROm, morning stiffness, swan neck deformity, bautonnieres, deviation, carpel tunnel syndrome, hammer toe, Question: are joint effected or just one Answer: usually joints Question: def of Answer: involving joints Question: are joints effected yes or noAnswer: yes Question: def of swan neck Answer: of DIP joint with hyperextension of PIP joints Question: def of boutonnieres Answer: hyperextension of DIP joint with flexion of PIP Question: what are nodules Answer: firm tissue nodules over elbow, MCP joints, toes Question: when does pain and how long does it last Answer: occur in the morning and more than an hour Question: what are the complcations of RAAnswer: of effected joints and problems of immobility Question: three complications of pt with RAAnswer: , pleuritis, pericarditis Question: def of Answer: blood vessel Question: what is the Dx on Answer: H & P, diagnostic Question: can it be Answer: Question: what are goals for RA Answer: relieve s/s, stop or reduce destruction, and maintain function Question: diagnostic tests: what is the factor? Answer: it will be present in most with RA Question: diagnostic : what will the ESR be Answer: typically it is Question: diagnostic tests: why is an xray done, and Answer: at the joints and is done to show characteristic joint changes of the disease Question: rest: when is it Answer: during flare ups (both joint and total body rest) Question: why does inflamed joints helpAnswer: to provide joint rest Question: why is therapy and exercise done Answer: to maintain muscle strength and joint Question: Why ROm be done Answer: to maintain joint function and prevent Question: meds: why are NSAIDS and givenAnswer: to inflammation Question: meds: why are used Answer: to reduce acute pain and Question: meds: what do doAnswer: they alter the disease course and reduce Question: meds: why are used Answer: to manage RA when the disease is or unresponsive to other meds Question: meds: what is the most commonly used Answer: methotrexate Question: meds- : what does it do Answer: they inhibit prostaglandin synthesis and activity,reducing inflammation. It also has an analgesic and antipyretic effect. It inhibits platelet aggregation and normal blotting. Question: meds- aspirin: what is a good daily dose for anti effects Answer: 2.6-4.8 G/day Question: meds- aspirin: implications Answer: assess for contraindications (allergies, bleeding disorders), stop drug if rash,hives, or of gastrointestinal bleeding develop Question: meds- : administrationAnswer: give crushed or whole with food or milk to gastric irratation Question: meds- : pt teaching Answer: always take with food or milk, do not substitute acetaminophen for aspirin because it doesn't have the antiinflamatory effect, report dark stools, vomiting of blood, abnormal bleeding, blurred vision, rashes, do not take with it Question: meds- aspirin: why shouldn't the pt take with aspirin Answer: it greatly increases the risk for bleeding Question: meds- NSAIDS: names Answer: ibuprophin (motrin), (anaprox), tolmetin (Tolectin) Question: meds- NSAIDS: what do they do Answer: used to arthritis and other causes of inflamation, they all inhibit prastaglandin synthesis reducing inflammation. Question: meds- other NSAIDS: Answer: give with food or milk to gastric effect Question: meds- other : nursing implications Answer: obtain baseline weight and VS, carefully monitor elderly or pt with kidney function for toxicity Question: meds- NSAIDS: pt teaching Answer: taje as ordered to constant blood levels, may take several weeks for full effect to occur, take with food or milk, weigh weekly, avoid aspirin and alcohol Question: meds- generation NSAIDS- COX-2 inhibitors: names Answer: celecoxib (celebrex), (vioxx) Question: meds- generation NSAIDS- COX-2 inhibitors: what do they do Answer: they are that suppress inflammation and pain Question: meds- generation NSAIDS- COX-2 inhibitors: adminstrationAnswer: by mouth w/o regard to meals, take with full glass of water stay upright fot 15-30 after taking Question: meds- second generation - COX-2 inhibitors: client teaching Answer: notify doctor of stools, rash edema, or unexplained weight gain Question: : why is it done Answer: to pain and repair or replace joints damaged by RA Question: : what is arthrodesis; why is it done Answer: fusion; used to stabilize joints Question: : why is arthroplasty done Answer: for cases of deformity and joint destruction Question: what is Answer: used to circulating antibodies , moderating the autoimmune response Question: what is total irradiationAnswer: it decreases the total lymphocyte Question: what to the synovial fluid (synovium)Answer: it thickens and it builds up on the joints and the joints then fuse together (this is the ) Question: what magor joints are Answer: wrist, feet Question: what is the goal Answer: keep pt out of Question: med: (rheumatrex): use Answer: RA ( slow , decrease joint damage, prevent deformities) Question: med: methotrexate (rheumatrex): reactions Answer: N, , alopecia Question: med: methotrexate (rheumatrex): Answer: it immunosuppresses the body in turn decreases the body's autoimmune response Question: med: methotrexate (rheumatrex): what does it the risk for Answer: infections, b/c immunity is Question: med: methotrexate (rheumatrex): s/s of Answer: increased temp and WBC, more Question: what time of day is pain the Answer: in the AM for >1 hour Question: when are used Answer: when in Question: what is a normal BS on steroidsAnswer: 200 mg/dL Question: calcium supplement: why should no more than 600 mg be at a time Answer: that is all that can be absorbed in one day Question: vit D- how much be given daily Answer: 800-3,00 untis Question: calcium: should calcium corbenate (TUMS) be with or w/out food Answer: with food b/c it is an ant Question: calcium: should citrate be given with or without food Answer: w/ out food Question: does temp or decrease in flair up Answer: it increases Question: when should RA pt begin to take Answer: Question: do DMARDS work Answer: no, a while so bridge with anti-inflamatories Question: med- methotrexate: how long does it take for it to Answer: 3-6 Question: med: (Hydroxyxhloroquine): use Answer: RA and LUpes, Question: med: (Hydroxyxhloroquine): class Answer: Question: med: (Hydroxyxhloroquine): adverse reactions Answer: irritability nervousness, retinal and corneal changes, , N/V, Question: med: plaquenil (Hydroxyxhloroquine): what type of exam should be done with this drug Answer: and eye Question: med: TNF : what are they Answer: meds used for more severe s/s of RA |
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