Rheumatoid arthritis Word Scramble
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Question | Answer |
calcium: should calcium corbenate (TUMS) be given with or w/out food | with food b/c it is an ant acid |
it has periods of remission followed by ________ | exacerbations |
what are Treatment goals for RA | relieve s/s, stop or reduce joint destruction, and maintain function |
meds: what is the most commonly used immunosuppresant | methotrexate |
meds: what do dmards do | they alter the disease course and reduce obstruction |
what is pannus | vascular granulation tissue (new blood vessels), in the synovial membrane- it destroys joint tissue |
what are s/s of inflames joints | they are swollen red and painful |
diagnostic tests: what will the ESR be | typically it is elevated |
the rheumatoid factor bind with what to form immune complexes | the IgG |
meds- second generation NSAIDS- COX-2 inhibitors: names | celecoxib (celebrex), rofecoxib (vioxx) |
med: methotrexate (rheumatrex): what does it increase the risk for | infections, b/c immunity is suppressed |
when does pain occur and how long does it last | occur in the morning and lasts more than an hour |
Because of this WBCs are atracted to the area; what do the WBCs do to the joint tissue | they release enzymes that distroy the joint tissue |
are joints effected symetrically yes or no | yes |
meds: why are corticosteroids used | to reduce acute pain and inflammation |
what are rheumatoid nodules | firm subcutaneous tissue nodules over elbow, MCP joints, toes |
do DMARDS work immediately | no, thakes a while so bridge with anti-inflamatories |
what is the Dx based on | H & P, diagnostic tests |
def of boutonnieres deformity | hyperextension of DIP joint with flexion of PIP joint |
meds- aspirin: nursing implications | assess for contraindications (allergies, bleeding disorders), stop drug if rash,hives, or signs of gastrointestinal bleeding develop |
does is affect women more then men or men more then women | women more then men |
diagnostic tests: what is the Rheumatoid factor? | it will be present in most people with RA |
diagnostic tests: why is an xray done, and where | at the effected joints and is done to show characteristic joint changes of the disease |
med: methotrexate (rheumatrex): use | RA ( slow disease, decrease joint damage, prevent deformities) |
three complications of pt with severe RA | vasculitis, pleuritis, pericarditis |
what is plasmapherisis | used to remove circulating antibodies , moderating the autoimmune response |
what does the body see as a foreign substance; what does it make inresponse to the foreign substance | the IgG immunoglobulin; IgG immunoglobulin autoantibodies (aka rheumatoid factor) |
meds- other NSAIDS: pt teaching | taje as ordered to maintain constant blood levels, may take several weeks for full effect to occur, take with food or milk, weigh weekly, avoid aspirin and alcohol |
at what age does it usually develop | between age 30 -50 |
why does splinting inflamed joints help | to provide local joint rest |
Surgery: why is arthroplasty done | for cases of gross deformity and joint destruction |
def of RA | a chronic, systemic inflammatory disorder that primarily affects the joints |
systemic s/s | anorexia, weight loss, and nonspecific aching and sitffness, fatigue, anemia, low grade fever, rheumatoid nodules |
can it be cured | no |
is RA systemic | Yes - it effects other tissues along with joint |
why is physical therapy and exercise done | to maintain muscle strength and joint mobility |
meds: why are immunosuppressants used | to manage RA when the disease is aggressive or unresponsive to other meds |
do joint manifestations develop slowly or fastly | slowly |
s/s of joint involvement | swelling, stiffness, warmth, tenderness, pain, limited ROm, morning stiffness, swan neck deformity, bautonnieres, ulnar deviation, carpel tunnel syndrome, hammer toe, |
what is total lymphoid irradiation | it decreases the total lymphocyte levels |
meds- second generation NSAIDS- COX-2 inhibitors: client teaching | notify doctor of tarry stools, rash edema, or unexplained weight gain |
what do the T lumphocytes (tcells) do? | they migrate to the joint and infiltrate the synovial membrane, causing an immune resonse |
med: plaquenil (Hydroxyxhloroquine): class | DMARDS |
meds- aspirin: administration | give crushed or whole with food or milk to prevent gastric irratation |
what happens to the synovial fluid (synovium) | it thickens and it builds up on the joints and the joints then fuse together (this is the pannus) |
med: methotrexate (rheumatrex): action | it immunosuppresses the body which in turn decreases the body's autoimmune response |
meds- second generation NSAIDS- COX-2 inhibitors: adminstration | by mouth w/o regard to meals, take with full glass of water stay upright fot 15-30 minutes after taking |
when should RA pt begin to take DMARDS | ASAP |
rest: when is it needed | during acute flare ups (both joint and total body rest) |
med: plaquenil (Hydroxyxhloroquine): adverse reactions | irritability nervousness, retinal and corneal changes, anorexia, N/V, |
when are steroids used | when in exasterbation |
meds- aspirin: why shouldn't the pt take alcohol with aspirin | it greatly increases the risk for gastrointestinal bleeding |
calcium: should calcium citrate be given with or without food | w/ out food |
it is an autoimmune disorder, what is the cause | unknown |
what magor joints are effect | hands wrist, feet |
what is a normal BS while on steroids | around 200 mg/dL |
meds: why are NSAIDS and aspirin given | to reduce inflammation |
med: methotrexate (rheumatrex): s/s of infection | increased temp and WBC, more fatigue |
meds- second generation NSAIDS- COX-2 inhibitors: what do they do | they are NSAIDS that suppress inflammation and pain |
vit D- how much should be given daily | 800-3,00 untis day |
med- methotrexate: how long does it take for it to work | 3-6 weeks |
meds- aspirin: pt teaching | 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 |
med: plaquenil (Hydroxyxhloroquine): use | RA and LUpes, antimalarial |
what is produced when the immune response is initiated | IgG immunoglobulin |
Why should ROm be done | to maintain joint function and prevent contractures |
med: methotrexate (rheumatrex): adverse reactions | N, stomatitis, alopecia |
are multiple joint effected or just one | usually multiple joints |
Surgery: what is arthrodesis; why is it done | joint fusion; used to stabilize joints |
meds- other NSAIDS: administration | give with food or milk to minimize gastric effect |
meds- aspirin: what does it do | they inhibit prostaglandin synthesis and activity,reducing inflammation. It also has an analgesic and antipyretic effect. It inhibits platelet aggregation and normal blood blotting. |
what is the goal | keep pt out of exasterbations |
calcium supplement: why should no more than 600 mg be given at a time | because that is all that can be absorbed in one day |
meds- other NSAIDS: names | ibuprophin (motrin), Naprixin (anaprox), tolmetin (Tolectin) |
what time of day is pain the worse | in the AM for >1 hour |
def of polyarticular | involving multiple joints |
does temp increase or decrease in flair up | it increases |
Surgery: why is it done | to relieve pain and repair or replace joints damaged by RA |
the distruction of joint tissue causes what | inflammation |
meds- aspirin: what is a good daily dose for anti inflamatory effects | 2.6-4.8 G/day |
def of swan neck deformity | flexion of DIP joint with hyperextension of PIP joints |
med: TNF blockers: what are they | cancers meds used for more severe s/s of RA |
meds- other NSAIDS: what do they do | used to manage arthritis and other causes of inflamation, they all inhibit prastaglandin synthesis reducing inflammation. |
what are the primary complcations of RA | destruction of effected joints and problems of immobility |
med: plaquenil (Hydroxyxhloroquine): what type of exam should be done periodically with this drug | and eye exam |
meds- other NSAIDS: nursing implications | obtain baseline weight and VS, carefully monitor elderly or pt with reduced kidney function for toxicity |
def of vasculitis | blood vessel inflamation |
Created by:
jmkettel
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