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Krystan: Semester Two Nursing School > 2800 Exam One > Flashcards

2800 Exam One Flashcards

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1
Q

What are three major factors affecting professional nursing practice today?

A

Expanding knowledge and technology
Increasingly diverse populations
Consumerism

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2
Q

What are some ways expanding knowledge and technology impact patient care?

A

More common language and clear communication in HC
Earlier detection of diseases
Better diagnosing of diseases
More use of genetic information
Better technology leading to longer lifespans

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3
Q

How does an increasingly diverse population impact patient care?

A

More patients with comorbid conditions and chronic illnesses, meaning more care to coordinate
Different cultural beliefs/practices/expectations
Problems and challenges around immigration and insurance

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4
Q

What is the impact of consumerism on patient care?

A

Patients are consumers of healthcare and are more involved in their care with higher expectations/knowledge of their care

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5
Q

What are some ways the economy impacts healthcare?

A

Employment/insurance
Cost of medications and procedures
Impacts which patients we see and how we treat their conditions

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6
Q

What are some key features/outcomes of healthcare legislation?

A 
Confidentiality laws
Emergency care laws
Advanced directive laws
Informed consent laws
Laws about safety and scope of practice
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7
Q

How does collective bargaining impact nursing?

A

It gives nurses more of a voice and ability to advocate for themselves in things like wages, safety, and benefits

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8
Q

What are some ways nurses can impact healthcare policy?

A

Joining MNA and professional groups
Taking leadership/legislative roles
Educating/talking with government officials
Voting

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9
Q

What are some other noteworthy healthcare trends in america today?

A 
Aging population
Increased use of CAM
More intraprofessional collaboration
Expanded career roles for nurses
Increased use of NAP
Nurse and nurse educator shortages
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10
Q

What are some factors that increase host susceptibility to infection?

A 
Being young or old
Skin breakdown
Surgical incisions
Illness
Substance abuse
Certain medications 
Chronic diseases
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11
Q

Why are those with chronic diseases at higher risk for infection?

A

Because chronic disease limits infection fighting ability and wears down the immune system

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12
Q

What are standard precautions?

A

Things that should be done when caring for all patients, like hand washing and wearing gloves when necessary

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13
Q

When should the nurse wear masks and eye protection?

A

When any splashing of body fluids might occur due to close contact

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14
Q

When should we wear gloves?

A

When we may be exposed to any body fluid or secretions
Exposure to mucous membranes
Breaks in skin for the nurse or patient

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15
Q

What are transmission based precautions?

A

Precautions used in patients with a known or suspected infection, especially ones where direct contact with environmental surfaces could transmit the pathogen

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16
Q

What diseases/conditions necessitate the use of transmission based precautions?

A

MRSA, c-diff, VRE

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17
Q

What type of room should a patient on transmission precautions be placed in?

A

Private if possible
At least three feet from other patients with a dividing curtain in not
Limit transportation of this patient

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18
Q

What PPE should be used for transmission precautions and when should it be put on?

A

Gloves, gown, disposable/designated equipment

Put on before entering the room

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19
Q

What should be done when transporting patients on contact or droplet precautions?

A

Put a mask on them

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20
Q

What are droplet precautions?

A

For when pathogens can spread through large droplets of respiratory/mucous membrane secretions. These large droplets are not able to spread more than about 3 feet from the patient

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21
Q

With what conditions do we use droplet precautions?

A

Cold
Flu
Pneumonia
Pertussis

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22
Q

What are some good practices to use for droplet precaution patients?

A

Private room
Limited transportation
Teach respiratory hygiene

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23
Q

What type of PPE should be used for droplet precautions?

A

Gloves
Gown
Mask
Eye shield

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24
Q

What are airborne precautions?

A

For diseases where pathogens are small and stay suspended in the air, and are therefore able to be infectious over long distances

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25
Q

With what diseases should we use airborne precautions?

A 
TB
Measles
SARS
Chicken pox
Shingles
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26
Q

What type of room should airborne precaution patients be placed in?

A

Negative pressure airborne infection isolation room

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27
Q

What are features of an airborne infection isolation room?

A

A room with negative pressure that discharges the air and exchanges it outside the room

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28
Q

What is a HEPA filter?

A

High efficiency particulate air system

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29
Q

What PPE should be used for airborne precautions?

A

Fitted respirator mask (N95 or PAPR)
Gloves
Gown
Mask

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30
Q

Genetics

A

Study of genes and their role in inheritance

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31
Q

Genomics

A

Study of a persons genes and how they interact with one another and the environment

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32
Q

what are some uses for genetic testing?

A

Early detection
Risk assessments
Donor-transplant matches
Improved diagnoses of diseases

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33
Q

What are some things patients and family members should be taught concerning genetic testing?

A

Cost and insurance
What a positive test means and doesnt mean
Emotional impact of results
Changes in lifestyle that may be needed because of results
Family impacts
What a negative result means

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34
Q

What should a basic professional nurse be able to do in relation to genetics?

A

Educate patients on what it is
Connect them to resources
Advocate for patients to get genetic services
Be able to identify basic genetic patterns and risk factors

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35
Q

What are some psychological and emotional issues related to providing genetic information?

A 
Anxiety
Uncertainty about whether disease will develop
Stress
Family tension
Depression over results
Decisions about whether to have kids
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36
Q

What are some ethical concerns related to genetic testing?

A

Patients making healthcare decisions based on inadequate information
Potential insurance discrimination
Financial restrictions on genetic testing access
Access and privacy for genetic information

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37
Q

What act protects patient genetic information?

A

GINA (genetic information non discriminatory act)

only protects in cases of health insurance, not life or long term insurance

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38
Q

Why is it important for a person to know his or her family history even though genetics cannot changed?

A

Because a family history can highlight genetic risk factors/predispositions, and the patient can change their lifestyle or diet to help eliminate some risk of developing that disease

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39
Q

What are some red flags in a family history that signal increased risk for genetic diseases?

A

Multiple relatives affected across multiple generations
Early onset diseases
First degree relatives affected
Disease affecting those of an opposite gender from those normally affected

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40
Q

What are the six QSEN competencies?

A 
Patient centered care 
Teamwork and collaboration
Safety 
Quality improvement 
Informatics 
Evidence based practice
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41
Q

What are some of the knowledge, skills, and attitudes associated with the competency of safety?

A

Following safety recommendations
Communicating concerns and errors
Helping to design systems to improve safety

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42
Q

Which organization surveys long term and transitional care facilities in Minnesota in areas of quality and safety?

A

Minnesota department of health

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43
Q

What is a survey?

A

An unannounced, multi-day review of a facility to evaluate care, quality of care, and whether standards are being met

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44
Q

What happens at the end of a survey process?

A

An exit interview, where the DOH sits down with the facility and talks over the survey. A survey report is also sent to the facility

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45
Q

What is a violation on a survey?

A

A facility failing to meet a state regulation

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46
Q

What is a deficiency on a survey?

A

Facility failing to meet a federal/CMS regulation

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47
Q

What are remedies in terms of a survey?

A

Remediation plan to fix the identified problem (usually education, system changes, or procedure changes)

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48
Q

What are potential results if a problem found in survey is not fixed?

A

Fines or shutting down the facility

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49
Q

What is a sentinel event?

A

A never event

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50
Q

What are some of the skills, knowledge, and attitudes associated with quality improvement?

A

Using quality measures to understand performance
Identifying gaps between local and best practices
Helping in investigations of issues
Collecting data using quality improvement tools

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51
Q

What is the definition of “MN clinical quality indicators”?

A

A measure of clinical quality of care derived from assessment of every resident

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52
Q

What are some of the areas looked at when determining the effectiveness of quality/safety in care facilities in MN?

A 
Quality of life
Continence
Patient satisfaction
Nutrition
Behavioral functioning
Accidents and falls
Skin care
Use of restraints
Infections
Psychosis
Declining mobility
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53
Q

What is the Minimum Data Set?

A

Federally mandated patient assessments gathered upon admission and then periodically at long term care facilities/TCUs to evaluate patient care and determine how it will be compensated by CMS

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54
Q

Who does the MDS survey?

A

A MDS nurse

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55
Q

Define evidence based practice

A

Integrating best current evidence with clinical expertise and client preference to deliver optimal health care

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56
Q

What are the knowledge, skills, and attitudes associated with evidence based practice?

A

Reading research
Looking at evidence reports and clinical practice guidelines
Willingness to improve care through new knowledge

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57
Q

What do we base an individual patient care plan on?

A

Patient values, clinical expertise, and evidence

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58
Q

What are the six steps of the EBP process?

A 
Ask an answerable question
Compile evidence
Analyze/synthesize evidence
Implement evidence in practice
Evaluate the outcome in the clinical setting
Share results of EBP change
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59
Q

Describe the PICOT format for asking an EBP question

A 
Patient/problem
Intervention to be taken
Comparison against baseline/old method 
Outcome
Time period (if applicable)
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60
Q

What is the best kind of evidence when using EBP?

A

Systematic reviews or meta-analyses of randomized controlled trials

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61
Q

What are some defining characteristics of acute illness?

A

Rapid onset
Short duration
Self limiting
Responds to treatment

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62
Q

What are some defining characteristics of chronic illness?

A

Lasts longer than 6 months
No quick recovery
Usually irreversible

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63
Q

Simultaneous presence of two or more diseases

A

Comorbidity

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64
Q

Define disability

A

Physical or mental condition that limits movement, senses, or activities

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65
Q

What are the top 3 causes of death in the United States?

A

Coronary artery disease
Cancer
COPD

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66
Q

What are contributing factors to the increase in chronic illness?

A 
Poor diet
Lack of activity
Tobacco/alcohol 
People living longer
Lower infant mortality rates
Eradication of some diseases
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67
Q

What are some impacts of chronic illness on a chronically ill child?

A 
Delayed development
Stress
Functional impairment
Missed school time
Social isolation
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68
Q

What are some impacts for the parents of a chronically ill child?

A 
Strain of caring for child
Strain of caring for other children
Missed work days
Financial cost
Grief
Marital strain
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69
Q

What are some chronic illnesses that children deal with?

A 
Asthma
Diabetes
Cancer
Hypertension
ADHD
Autism
Mental health issues
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70
Q

What are some impacts on the siblings of chronically ill children?

A 
Increased responsibility
Feeling ignored by parents
Jealousy 
Behavioral/emotional issues 
Guilt
Anger
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71
Q

Explain the chronic illness trajectory

A

Onset —> stable —>acute (complications arise) —> comeback (gradual recovery) —>crisis (life threatening issue or issues) —> unstable/downward —> dying.
Can go through different numbers of those stages or repeats, but begins are ends about the same. Peak function is rarely regained

72
Q

How does the chronic illness trajectory inform the work of the nurse?

A

The nurse can plan and implement the best care according to the stage the patient is in, and not have unrealistic expectations according to where the patient is in the trajectory

73
Q

What are the seven tasks of the chronically ill?

A

Prevent and manage a crisis
Adhere to treatment
Control symptoms
Reorder time
Adjust to changes over the course of the disease
Prevent social isolation
Attempt to normalize interactions with others

74
Q

What are some things that make treatment adherence harder?

A

Time consuming
Difficult
Painful
Hard to remember

75
Q

A mark of disgrace associated with something is…

A

Stigma

76
Q

What does the term “normalizing” mean?

A

Creating a new state of normalcy in the face of something life-changing, such as chronic illness

77
Q

for chronically ill kids, normalization should be the goal

A

this includes school, discipline, routines, and structures as much as possible!

78
Q

How does chronic illness impact infants?

A

Separation from parents, which can create trust issues

External stimuli is often painful

79
Q

How does chronic illness affect toddlers development?

A

They have increased parental dependence and are unable to explore their world like normal

80
Q

How does chronic illness impact preschool age children’s development?

A

Limited ability to master self-care
Limited socialization opportunity
Overprotected by family

81
Q

How does chronic illness impact school age children?

A

Limited ability to achieve and compete
Limited socializing
Falling behind in education

82
Q

How does chronic illness impact adolescents and their development?

A

They feel different from their peers
Increased family dependence (autonomy negatively impacted)
Fear about the future
Risk taking behaviors
Limited achievement of abstract thought mastery

83
Q

Young-old adults

A

Those 65-74 years old

84
Q

Old old adults

A

Those over 85 years old

85
Q

Frail older adults

A

Over 75 years old with physical, mental, or cognitive conditions that affect ability to perform ADLs

86
Q

Which Erickson stage correlates to older adulthood?

A

Ego integrity versus despair

87
Q

Which Erickson stage relates to middle adults?

A

Generativity versus stagnation

88
Q

What is the number one goal for managing chronic illness across the lifespan?

A

Maximizing independence

89
Q

What is social justice?

A

Fairness and upholding moral, legal, and humanistic principles

90
Q

What are the three facets of social justice as pertains to nursing care?

A

Providing quality, non-discriminatory care
Universal access to healthcare, regardless of situation
Advocating for legislation and policy that upholds social justice ideals

91
Q

What are some gender differences as relates to chronic illness?

A

Women are more likely to be chronically ill
Women are less likely to be correctly diagnosed and receive necessary treatment
Women are more likely to live in poverty and less likely to have health insurance
Women usually live longer than men

92
Q

What are some groups that are considered vulnerable or special older adult populations?

A 
Minority
Low SES
Chronically ill
Cognitively impaired
Rural
Homeless
Frail older adults
Women
93
Q

What factors besides dementia can influence cognition?

A

Declining health
Acute illness
Delirium
Depression

94
Q

What is the number one barrier to health care access for rural adults?

A

Transportation

95
Q

What are some other barriers to healthcare for rural adults?

A

Limited healthcare workers and facilities
Lack of quality healthcare
Social isolation
Financial limitations

96
Q

What are four factors associated with homelessness?

A

Low income
Reduced cognitive capacity
Living alone
Lack of affordable housing

97
Q

What are risk factors for being considered frail?

A 
Disability
Chronic conditions
Dementia
Smoking 
Falls
Unintended weight loss
Exhaustion
Impaired mobility
98
Q

What are common health problems of frail older adults?

A

Malnutrition
Dehydration
Weakness
Decreased mobility

99
Q

What are four risk factors for community elder mistreatment?

A

Physical and cognitive dysfunction
Psychiatric diagnoses
Alcohol and drug abuse
Decreased social support

100
Q

What are some manifestations of neglect?

A 
Pressure ulcers 
Weight loss
Poor hygiene
Depression
Agitation
Behavioral and emotional issues
101
Q

How is self-neglect defined?

A

Being unable to meet one’s own needs and refusing help

102
Q

What should the nurse do when suspecting elder mistreatment?

A

Screen for mistreatment (always screen first!)
Conduct history and head to toe
Develop safety plan
Document and report findings
Get social worker and protective services involved

103
Q

What are some main caregiver stressors?

A 
Lack of respite from responsibilities
Change in family roles
Conflict
Inability to care for self
Change in living conditions
Not having adequate knowledge or resources
104
Q

What are some positive aspects of caretaking?

A

Learning new skills
Knowing loved one is receiving good care
Finding opportunities for intimacy and bonding

105
Q

What are some ways the nurse can help prevent and treat caregiver stress?

A 
Encourage caregivers to take care of themselves 
Connect them to support groups
Encourage social contact
Connect them to respite care services
Help them find joy
106
Q

How could the nurse help support siblings of a child with special needs/chronic illness?

A

Acknowledge siblings skills, coping ability, and caring abilities
Limit caretaking responsibilities of siblings
Listen to them and praise them for positive actions

107
Q

Where are patients normally cared for by a trained professional for a short period of time after an illness or injury?

A

Skilled care facility/TCU

108
Q

Custodial care is also known as…

A

Long term care

109
Q

What can home health care assist with?

A

Meals
Bathing
Cleaning
Other ADLs/IADLs

110
Q

When determining the best care placement options for a patient, what is looked at most heavily?

A

Functional ability

111
Q

What are three factors that precipitate placement in a long term care facility?

A

Rapid deterioration
Caregiver inability due to stress or burnout
Alteration/loss of family support system

112
Q

Transitioning to a long term care facility can cause what for the client? (Nursing diagnosis)

A

Relocation stress syndrome

113
Q

What are diseases in older adults harder to assess and diagnose?

A

Symptoms are underreported
Clients alter functional systems to cope with symptoms
Fear of healthcare workers and institutions can cause them to not say anything

114
Q

Cascade disease pattern

A

Symptoms or treatments for one disease or problem leading to other diseases/injuries/problems

115
Q

Geriatric assessment tools primarily focus on..

A

Functional ability

116
Q

What is the goal of rehabilitation?

A

To help clients adapt to or recover from acute functional decline. Maximizing functioning and physical capability

117
Q

What are some things that older adults with chronic conditions are at risk for?

A

Functional decline
Infection
Institutionalization

118
Q

What are some factors that influence the rehabilitation process for older adults?

A

Preexisting conditions
Current health and functional status
Loss of function due to inactivity or immobility

119
Q

Deconditioning

A

Loss of function due to inactivity or immobility

120
Q

What helps prevent deconditioning?

A

Passive and active range of motion

121
Q

What are some common causes of accidental death?

A

Falls
Motor vehicle accidents
Fires

122
Q

What are some common causes of med errors by older adults?

A 
Decreased vision
Forgetfulness
Overuse of OTC meds
Non-compliance
Not being able to afford meds
Not taking due to side effects
123
Q

When evaluating nursing care with older adults, what should the nurse focus on?

A

Functional improvement and quality of life
Changes in ADLs/IADLs
How the patient feels like its going

124
Q

What are some major musculoskeletal effects of immobility?

A

Decreased muscle strength, tone, and endurance
Atrophy
Bone demineralization
Hypercalcemia/negative bone calcium uptake

125
Q

What are joint contracturas?

A

Limitation of passive ROM at the joint (hard to straighten)

126
Q

What are metabolic effects of immobility?

A

Decreased metabolism
Negative nitrogen balance
Hypercalcemia
Decreased stress hormone production

127
Q

What are the effects of immobility on the cardiovascular system?

A

Venous stasis
Decreased ability to adjust BP to positional changes
Diminished vasopressor mechanism (hypertension)
Edema

128
Q

What are respiratory effects of immobility?

A 
Decreased need for oxygen
Decreased chest expansion and vital capacity
Secretion retention 
Loss of respiratory muscle strength
Poor abdominal tone (hinders coughing)
129
Q

What are gastrointestinal effects of immobility?

A

Distention due to poor abdominal tone
Constipation
Anorexia

130
Q

What are GU effects of immobility?

A

Less gravitational force causing difficulty voiding, urinary retention, and renal caliculi
Increased UTI risk

131
Q

What are integumentary system impacts of immobility?

A

Altered tissue integrity and circulation
Poor wound healing (especially if malnourished)
Pressure and moisture leading to skin breakdown

132
Q

What are some psychological effects of immobility?

A 
Social isolation
Anxiety
Sensory deprivation 
Helplessness
Depression
Body image issues 
Anger and aggression
Regression
Sluggish intellectual or psychomotor response
133
Q

What are some nursing cares to manage the musculoskeletal effects of immobility?

A 
Upright posture
Maintain ROM and joint alignment
Anti-embolism stockings
Serum calcium monitoring
Keep patient active as much as possible
134
Q

What are some nursing cares to manage the metabolic effects of immobility?

A 
Mobilize ASAP
ROM
High protein, high fiber diet
Low stress environment 
Do everything possible to prevent pressure ulcers
135
Q

What are some nursing cares to manage the cardiovascular effects of immobility?

A 
Monitor peripheral pulses and skin temperature
TED hose/stockings
Abdominal support
Monitor hydration/BP/I&O
Sequential compression devices
136
Q

What are some nursing cares to manage the respiratory effects of immobility?

A 
Promote exercise and deep breathing
Position for chest expansion
Promote coughing
Incentive spirometry
Listen to lung sounds 
Immunizations
Hydration
Reposition frequently
137
Q

What are some nursing cares to manage the GU effects of immobility?

A 
Monitor bowel sounds
Small, frequent meals
Keep patient sitting upright
Bowel training program
Protein supplements
High fiber diet
138
Q

What are some nursing cares to manage the GU effects of immobility?

A 
Position upright to void
Hydrate
Give antibiotics as needed
Monitor I&O
Bladder training
139
Q

What are some nursing cares to manage the integumentary effects of immobility?

A 
Turn and reposition frequently
Frequent skin inspection
Encourage self care 
Minimize pressure on skin
Adequate protein
Keep patient clean if incontinent
140
Q

What are some nursing cares to manage psychosocial effects of immobility?

A 
Get them out and about
Encourage socializing
Set and celebrate goals
Orient them to place and time
Diversional therapies
Comfort items (especially for kids)
141
Q

Muscular dystrophy

A

Genetic disease with gradual degeneration of muscle fibers

142
Q

What are some characteristics of Duchenne Muscular Dystrophy?

A 
Onset between 3 and 7 years old
Progressive weakness and wasting
Calf muscle pseudohypertrophy 
Loss of independent ambulation by 9-12 years old
Gower’s sign
Joint and muscle contracture
143
Q

What are some nursing management priorities for the patient with DMD?

A 
Promoting mobility and independence 
Encouraging growth and development
Prevention of isolation and complications
Support the family as disease progresses
Range of motion exercises
144
Q

Describe multiple sclerosis

A

Progressive, autoimmune degenerative disorder affecting nerves of the brain and spinal cord

145
Q

What are clinical manifestations and assessment findings in patients with MS?

A 
Blurred/double vision
Muscle weakness in extreme ties
Coordination and balance issues
Numbness and tingling
Vertigo
Tinnitus
Fatigue in hot weather 
Lhermitte’s sign
146
Q

What is Lhermitte’s sign?

A

A common manifestation in MS in which the patient feels an electric shock feeling down their spine with neck flexion

147
Q

What are common motor problems with MS?

A

Coordination and balance issues
Weakness
Walking/standing issues
Tremors

148
Q

What are common sensory problems with MS?

A

Hearing loss
Blurred or double vision
Red green color distortion
Blindness in one eye

149
Q

What are common cerebellar problems with MS?

A

Nystagmus (involuntary eye movement/shaking)
Ataxia (balance issues)
Dysarthria (slurred speech)
Dysphagia

150
Q

What are common bladder and bowel problems with MS?

A

Constipation
Spastic bladder
Flaccid bladder

151
Q

Spastic bladder

A

Bladder with a small capacity and unchecked contractions. Leads to urgency, frequency, and dribbling

152
Q

Flaccid bladder

A

Large urine capacity with no sensation, urge to void, pressure, or pain. Increases UTI risk

153
Q

What are common cognitive and emotional problems with MS?

A 
Short term memory issues
Sexual dysfunction
Problems with attention, planning, information processing, word finding
Anger
Depression
Euphoria
Self concept changes
154
Q

What are goals for the client with MS?

A 
Maintain ADLs 
Maximize neuromuscular function 
Manage fatigue
Adjust to illness
Reduce exacerbating factors 
Optimize psychosocial well-being
155
Q

What are some exacerbation triggers that MS clients should avoid?

A 
Infection
Trauma
Immunization
Childbirth
Stress
Changes in climate
Exhaustion
156
Q

What are some nutrition suggestions the nurse could offer for MS clients?

A

Minimal caffeine
Balanced, nutritious diet
High fiber intake

157
Q

What interventions can help with bowel and bladder problems with MS?

A

Anticholinergics
Self-catheterization
Increased fiber and fluid

158
Q

Osteoarthritis

A

Degenerative, progressive, non-inflammatory disorder of the synovial joints

159
Q

What are potential causes of OA?

A 
Trauma
Repetitive mechanical stress
Inflammation
Joint instability
Skeletal deformities 
Obesity
160
Q

What are primary assessment findings with OA?

A

Joint pain, especially with use.
Weight bearing joints affected most, along with hands
Pain gets worse with activity and barometric pressure changes
Can be asymmetrical

161
Q

What are potential complications of OA?

A

Stiffness
Loss of joint function
Deformity or instability of joint
Crepitus

162
Q

What is recommended related to comfort and rest for the patient with OA?

A

Rest often
Protect joints and use assistive devices
Avoid kneeling and squatting
Engage in low impact exercise

163
Q

What nutritional recommendations could be made for the OA patient?

A

Balanced diet
Exercise
Weight reduction if indicated

164
Q

What are some suggested CAM therapies for the OA patient?

A 
Ginger
Fish oil
Movement therapies
Acupuncture 
Massage
Hot/cold applications
165
Q

When should ice be used versus heat for OA?

A

Ice for acute inflammation and pain, heat for stiffness

166
Q

Rheumatoid arthritis

A

Chronic systemic autoimmune disease characterized by inflammation of connective tissue in synovial joints

167
Q

What are primary assessment findings with RA?

A 
Fatigue
Anorexia
Weight loss
Stiffness
Symmetrical joint pain and stiffness
Inflammation that often starts in the hands
Subluxation at the joints
168
Q

What are some extra-articular manifestations/complications of RA?

A 
Rheumatoid nodules
Enlarged spleen and low WBC count (felty syndrome)
Diminished lacrimal and salivary gland production (sjogien’s syndrome)
Dismissed grasp strength 
Pericarditis/myocarditis 
Neuropathy
Depression
Carpal tunnel
169
Q

What are rheumatoid nodules?

A

Granular type nodules often found on bony areas that are exposed to high pressure

170
Q

RA versus OA: weight

A

RA: lost or maintained weight
OA: often overweight or obese

171
Q

RA vs OA: affected joints

A

RA: small joints first, bilateral and symmetric
OA: weight bearing joints, spine. Often asymmetric

172
Q

RA vs OA: pain characteristics

A

RA: stiffness can last one hour to all day and may decrease with use. Pain is variable
OA: pain is often bad first thing in the morning and then may subside. Often worsens with use or disease progression

173
Q

What are priority patient goals for RA?

A

Maintain joint function and minimize deformity

174
Q

What is recommended for RA patients related to activity and rest?

A 
Joint protection
Assistive devices
Physical therapy
Resting throughout the day
Splints for joints
Avoid handshakes
175
Q

What are some common areas of patient concern/struggle with RA?

A 
Loss of function
Low self esteem
Altered body image
Fear of disability or deformity
Fatigue 
Depression
176
Q

How can the nurse provide the RA patient with psychologic support?

A 
Help patient understand disease progression and treatment
Listen to fears and concerns
Evaluate support system
Evaluate financial planning
Monitor for depression

Krystan: Semester Two Nursing School (13 decks)

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