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pn 141 test 1 book: med surg nursing pg 1060

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Question
Answer
show a chronic, systemic inflammatory disorder that primarily affects the joints  
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show women more then men  
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show between age 30 -50  
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it has periods of remission followed by ________   show
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it is an autoimmune disorder, what is the cause   show
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what do the T lumphocytes (tcells) do?   show
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what is produced when the immune response is initiated   show
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show the IgG immunoglobulin; IgG immunoglobulin autoantibodies (aka rheumatoid factor)  
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the rheumatoid factor bind with what to form immune complexes   show
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Because of this WBCs are atracted to the area; what do the WBCs do to the joint tissue   show
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show inflammation  
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what are s/s of inflames joints   show
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show vascular granulation tissue (new blood vessels), in the synovial membrane- it destroys joint tissue  
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show Yes - it effects other tissues along with joint  
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systemic s/s   show
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do joint manifestations develop slowly or fastly   show
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show swelling, stiffness, warmth, tenderness, pain, limited ROm, morning stiffness, swan neck deformity, bautonnieres, ulnar deviation, carpel tunnel syndrome, hammer toe,  
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show usually multiple joints  
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def of polyarticular   show
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show yes  
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def of swan neck deformity   show
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show hyperextension of DIP joint with flexion of PIP joint  
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show firm subcutaneous tissue nodules over elbow, MCP joints, toes  
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show occur in the morning and lasts more than an hour  
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what are the primary complcations of RA   show
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show vasculitis, pleuritis, pericarditis  
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def of vasculitis   show
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what is the Dx based on   show
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can it be cured   show
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what are Treatment goals for RA   show
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show it will be present in most people with RA  
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show typically it is elevated  
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diagnostic tests: why is an xray done, and where   show
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show during acute flare ups (both joint and total body rest)  
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why does splinting inflamed joints help   show
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show to maintain muscle strength and joint mobility  
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show to maintain joint function and prevent contractures  
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show to reduce inflammation  
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meds: why are corticosteroids used   show
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meds: what do dmards do   show
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show to manage RA when the disease is aggressive or unresponsive to other meds  
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meds: what is the most commonly used immunosuppresant   show
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meds- aspirin: what does it do   show
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meds- aspirin: what is a good daily dose for anti inflamatory effects   show
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meds- aspirin: nursing implications   show
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meds- aspirin: administration   show
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show 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 alcohol with it  
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meds- aspirin: why shouldn't the pt take alcohol with aspirin   show
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show ibuprophin (motrin), Naprixin (anaprox), tolmetin (Tolectin)  
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show used to manage arthritis and other causes of inflamation, they all inhibit prastaglandin synthesis reducing inflammation.  
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meds- other NSAIDS: administration   show
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meds- other NSAIDS: nursing implications   show
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meds- other NSAIDS: pt teaching   show
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meds- second generation NSAIDS- COX-2 inhibitors: names   show
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meds- second generation NSAIDS- COX-2 inhibitors: what do they do   show
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show by mouth w/o regard to meals, take with full glass of water stay upright fot 15-30 minutes after taking  
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meds- second generation NSAIDS- COX-2 inhibitors: client teaching   show
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Surgery: why is it done   show
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show joint fusion; used to stabilize joints  
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show for cases of gross deformity and joint destruction  
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what is plasmapherisis   show
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what is total lymphoid irradiation   show
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show it thickens and it builds up on the joints and the joints then fuse together (this is the pannus)  
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what magor joints are effect   show
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what is the goal   show
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med: methotrexate (rheumatrex): use   show
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med: methotrexate (rheumatrex): adverse reactions   show
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med: methotrexate (rheumatrex): action   show
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show infections, b/c immunity is suppressed  
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show increased temp and WBC, more fatigue  
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what time of day is pain the worse   show
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show when in exasterbation  
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what is a normal BS while on steroids   show
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calcium supplement: why should no more than 600 mg be given at a time   show
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vit D- how much should be given daily   show
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show with food b/c it is an ant acid  
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calcium: should calcium citrate be given with or without food   show
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show it increases  
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show ASAP  
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show no, thakes a while so bridge with anti-inflamatories  
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show 3-6 weeks  
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med: plaquenil (Hydroxyxhloroquine): use   show
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show DMARDS  
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show irritability nervousness, retinal and corneal changes, anorexia, N/V,  
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med: plaquenil (Hydroxyxhloroquine): what type of exam should be done periodically with this drug   show
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med: TNF blockers: what are they   show
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