pn 141 test 1 book: med surg nursing pg 1060
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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 ๐
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it is an autoimmune disorder, what is the cause | show ๐
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what do the T lumphocytes (tcells) do? | show ๐
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what is produced when the immune response is initiated | show ๐
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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 ๐
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Because of this WBCs are atracted to the area; what do the WBCs do to the joint tissue | show ๐
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show | inflammation
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what are s/s of inflames joints | show ๐
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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 ๐
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do joint manifestations develop slowly or fastly | show ๐
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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 ๐
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show | yes
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def of swan neck deformity | show ๐
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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 ๐
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show | vasculitis, pleuritis, pericarditis
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def of vasculitis | show ๐
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what is the Dx based on | show ๐
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can it be cured | show ๐
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what are Treatment goals for RA | show ๐
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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 ๐
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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 ๐
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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 ๐
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meds: what do dmards do | show ๐
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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 ๐
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meds- aspirin: what does it do | show ๐
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meds- aspirin: what is a good daily dose for anti inflamatory effects | show ๐
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meds- aspirin: nursing implications | show ๐
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meds- aspirin: administration | show ๐
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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 ๐
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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 ๐
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meds- other NSAIDS: nursing implications | show ๐
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meds- other NSAIDS: pt teaching | show ๐
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meds- second generation NSAIDS- COX-2 inhibitors: names | show ๐
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meds- second generation NSAIDS- COX-2 inhibitors: what do they do | show ๐
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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 ๐
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Surgery: why is it done | show ๐
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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 ๐
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what is total lymphoid irradiation | show ๐
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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 ๐
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what is the goal | show ๐
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med: methotrexate (rheumatrex): use | show ๐
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med: methotrexate (rheumatrex): adverse reactions | show ๐
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med: methotrexate (rheumatrex): action | show ๐
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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 ๐
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show | when in exasterbation
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what is a normal BS while on steroids | show ๐
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calcium supplement: why should no more than 600 mg be given at a time | show ๐
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vit D- how much should be given daily | show ๐
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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 ๐
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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 ๐
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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 ๐
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med: TNF blockers: what are they | show ๐
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