adult 1_ self-study module - Sheet1 Flashcards
What causes gout?
The kidneys cannot excrete enough or produce too much uric acid, leading to crystal deposits in joints that trigger inflammation.
How long do gout attacks typically last?
2-10 days
What is primary hyperuricemia?
A genetic lack of uricase prevents the breakdown of uric acid, leading to accumulation.
What is secondary hyperuricemia?
Conditions or drugs that either increase uric acid production or decrease its excretion.
What joints are commonly affected by gout?
The great toe, wrists, knees, ankles, and midfoot.
What are the signs and symptoms of acute gout?
Sudden onset at night, severe swelling and pain, sensitivity to touch, low-grade fever.
What are the signs and symptoms of chronic gout?
Multiple joint involvement, tophi (hard white nodules), joint deformities.
Why is kidney stone formation a concern in gout?
Increased uric acid can lead to stone formation in the kidney or urinary tract.
What lifestyle changes help prevent gout attacks?
Restrict alcohol, avoid foods high in purines, weight loss for obese patients, avoid fasting, and manage medication properly.
What nursing interventions help during a gout attack?
Educate on medication use, immobilize inflamed joints with bed rest or cradles, and assess motion limitations and pain levels.
What is a common procedure to relieve pain in swollen gouty joints?
Synovial fluid aspiration.
What medications are commonly prescribed for gout?
Oral colchicine and NSAIDs for inflammation and pain.
What drug is the first-choice treatment for gout?
Allopurinol, a xanthine oxidase inhibitor that decreases uric acid production.
What are the diagnostic tests for gout?
High serum uric acid level, 24-hour urine uric acid collection, synovial fluid aspiration with urate crystals, and X-ray showing eroded bone (tophi).
What is systemic lupus erythematosus (SLE)?
A multisystem inflammatory autoimmune disease caused by genetic, hormonal, environmental, and immune factors, leading to tissue destruction.
What are common symptoms of SLE?
Fever, weight loss, joint pain, fatigue, and increased risk for infections like pneumonia.
What are common skin symptoms of SLE?
Vascular skin lesions, alopecia, erythema, and a butterfly rash over the nose and cheeks.
What are the musculoskeletal effects of SLE?
Arthritis, swelling, stiffness, and an increased risk for bone loss or fractures.
How does SLE affect the cardiopulmonary system?
Tachypnea, cough, dysrhythmias due to fibrosis, pericarditis, myocarditis, endocarditis, hypertension, hypercholesterolemia due to steroid use, and increased clot risk (stroke, gangrene, MI).
What are the renal complications of SLE?
Proteinuria, nephropathy, scarring, and possible progression to end-stage renal disease (ESRD).
How does SLE affect the nervous system?
Headaches, psychosis, anxiety, depression, acute confusion, and cognitive problems.
What are the hematologic complications of SLE?
Anemia, leukopenia, thrombocytopenia, and coagulation disorders.
What nursing interventions are important for SLE?
Assess fever, inflammation, ROM, and fatigue, monitor I&O and daily weight, collect 24-hour urine samples, educate on sun exposure reduction, proper medication use, signs of infection, and energy-conserving techniques.
What dietary recommendations should be given to SLE patients?
Eat small, frequent meals with low sodium.
What medications are used to manage SLE?
NSAIDs for mild joint pain, corticosteroids for flare-ups, immunosuppressants (azathioprine, cyclophosphamide) to reduce organ damage, and antimalarial agents for fatigue and skin/joint problems.
What is a major side effect to monitor when using immunosuppressants in SLE?
Increased risk of blood clots.
Why are eye exams important for SLE patients?
Antimalarial agents can cause retinopathy.
What is the main diagnostic approach for SLE?
There is no single test; diagnosis is based on the presence of 4 or more clinical criteria.
What autoantibodies are commonly present in SLE?
ANA, anti-DNA, anti-Sm, and antiphospholipid antibodies.
What are the diagnostic criteria for SLE?
Discoid rash, hematologic disorder, immunologic disorder, malar rash, oral ulcers, neurologic disorder, nonerosive arthritis, pleuritis/pericarditis, photosensitivity, and renal disorder.
What additional tests are used to assess SLE?
H&P, CBC, serum complement, urinalysis, X-ray of affected joints, chest X-ray, and ECG to assess cardiac involvement.
What is fibromyalgia?
A chronic central musculoskeletal pain and fatigue condition caused by abnormal CNS processing.
What are the primary symptoms of fibromyalgia?
Fluctuating widespread burning pain, multiple tender points, pain sensitivity, memory lapses (“fibro fog”), numbness/tingling in hands or feet, restless legs syndrome, migraines, depression, anxiety, stiffness, trouble sleeping, and fatigue.
Who is more commonly affected by fibromyalgia?
Women.
What nursing interventions help manage fibromyalgia?
Encourage rest, regular gentle exercise, and stretching, limit sugar/caffeine/alcohol, promote a healthy diet, provide weight-loss resources for obese patients, and offer support group and counseling information.
What lifestyle modifications can help reduce fibromyalgia symptoms?
Reducing sugar, caffeine, and alcohol intake, maintaining a healthy diet, and engaging in regular, gentle exercise and stretching.
What medications are prescribed for fibromyalgia?
Pregabalin, duloxetine, and milnacipran for chronic widespread pain; SSRIs for depression.
What diagnostic criteria are used to confirm fibromyalgia?
Widespread Pain Index (WPI) with pain in at least 11/18 tender points over the past week and a history of widespread pain for at least 3 months.
What scoring system is used for fibromyalgia diagnosis?
Symptom Severity Index (SSI) is calculated along with the Widespread Pain Index.
What WPI and SSI scores indicate a fibromyalgia diagnosis?
WPI of 7 or more and SSI of 5 or more, OR WPI between 3 and 6 with an SSI of 9 or more.
