Exam 2 chapter 39 OA, RA, Gout

Question 1

Inflammation of the joint

Answer 1

Arthritis

Question 2

The symptom that most commonly causes a person to seek medical attention for rheumatic diseases

Answer 2

pain

Question 3

what are the most prevalent types of arthritis

Answer 3

osteoarthritis
Rheumatoid
Gout

Question 4

disease that involves the joints, bones and muscles

Answer 4

Rheumatic disease

Question 5

which clinical manifestations are shared by rheumatoid arthritis (RA) and Osteoarthritis (OA)

Answer 5

joint swelling
pain
stiffness

Question 6

which characteristic of rheumatoid arthritis (RA) differentiate it from other forms of inflammatory arthritis?

Answer 6

Pannus formation

it has a destructive effect on the adjacent cartilage and bone

Question 7

Raynaud’s phenomenon

Answer 7

cold and stress induced vasospasm causing episodes of digital blanching or cyanosis

Question 8

what are the classic symptoms of RA

Answer 8

joint pain
swelling
warmth 
erythema (redness)
lack of function 

onset is usually acute
bilateral and symmetric

Question 9

what is the cardinal sign of inflammatory arthritis that an appear even before pain?

Answer 9

morning stiffness

lasting at least 30 to 45 minutes

Question 10

name some extra-articular features of RA

Answer 10

fever
weight loss
fatigue
anemia
lymph node enlargement
Raynaud's phenomenon (cold and stress induced vasospasm causing episodes of digital blanching or cyanosis)
arteritis
neuropath 
scleritis
pericarditis

splenomegaly
Sjögren’s syndrome (dry eyes and dry mucous membranes)

Question 11

Sjögren’s syndrome

Answer 11

dry eyes

dry mucous membranes

Question 12

Rheumatic disorders with diffuse inflammation and degeneration in connective tissues are referred to as

Answer 12

connective tissue diseases

Question 13

what are some common connective tissue diseases

Answer 13

RA
systemic lupus erythematosus (SLE)
scleroderma

Question 14

The connective tissue disease that is a result of disturbed immune regulation that causes an exaggerated production of autoantibodies and antigens.

Answer 14

Systemic Lupus Erythematosus (SLE)

Question 15

what is the first choice in the treatment of RA

Answer 15

The use of traditional NSAIDs

Question 16

what are the primary goals in managing RA

Answer 16

decrease inflammation
manage pain
maintain join function
prevent or correct join deformity

Question 17

heat and cold therapy for RA

Answer 17

help relieve pain, stiffness, and muscle spasm
Ice is beneficial during periods of disease exacerbation
Ice application should not exceed 10 to 15 minutes at one time.

Question 18

Tx options for RA

Answer 18

drug therapy
rest
joint protection
heat and cold application
exercise
patient and family teaching

Question 19

Medical management of RA

Answer 19

NSAIDs and salicylates 
	inhibit the production of prostaglandins and provide anti-inflammatory effects and analgesia.
COX-2
	inhibit inflammatory processes 
	patient at risk for GI cimmpplications
DMARDS
	Methotrexate (Rheumatrex, Trexall)
	hydroxychloroquine (plaquenil) -antimalarial 
	biologic agents (immunomodulators)
	small-molecule agents

Question 20

The major end produce to purine catabolism?

Answer 20

uric acid.
primarily excreted by the kidneys
Increase cause GOUT

Question 21

what is the most common initial problem of Gout?

Answer 21

inflammation of the great toe (podagra)

other affect joints are midtarsal area of the foot, ankle, knee and writs.

Question 22

when does the onset of symptoms typically occurs in Gout?

Answer 22

at night with sudden swelling and excruciating pain peaking within several house.
low-grade fever

Question 23

what are some foods high in purine content which patient with Gout need to avoid?

Answer 23

anchovies
liver
wine
beer
red and organ meats
shellfish

Question 24

what will be prescribed for patient with acute Gout attack

Answer 24

antiinflammatory such as Colchincine
NSAID for pain management
corticosteroids
Adrenocorticotropic hormone (ACTH)

Question 25

future attacks of Gout are prevented by maintenance does of what?

Answer 25

Allopurinol (Zyloprim, Alloprim)

uricosuric such as probenecid (Benemid)

Question 26

when may systemic corticosteroid be used for Gout?

Answer 26

only if routine therapies are contraindicated or ineffective.

Question 27

Defect of purine metabolism will result in

Answer 27

hyperuricemia = GOUT

Question 28

crystalline deposits accumulating in articular tissue, osseous tissue, soft tissue and cartilage.

Answer 28

Tophi seen in patient with chronic Gout

Question 29

what will be the serum uric acid levels that will indicate gout?

Answer 29

6.8 mg/dL

Question 30

Nursing management for patient with gout

Answer 30

pain control 
joint rested and application of ice
self care measures 
avoidance of aspirin
medication compliance
restricting foods high in purines such as organ meats and shell fish.
limit protein foods, alcohol.
avoid starvation diets
increase fluids 2,000 ml/day
maintain normal body weight 
decrease Na, fat and cholesterol

Question 31

A patient with gout is taking Colchicine what should the RN teach the patient about this medication

Answer 31

causes diarrhea

Question 32

Probenecid (Benemid)

Answer 32

Risk of uric acid deposition in kidney

Question 33

Allopurinol (Zyloprim)

Answer 33

vomiting

abdominal pain