management of rheumatic disorders (4)

Question 1

is rheumatoid arthritis chronic or acute

Answer 1

chronic

Question 2

what is the etiology of rheumatoid arthritis?

Answer 2

autoimmune, unknown etiology

Question 3

what are risk factors of RA

Answer 3

smoking, genetics, viral or bacterial illness

Question 4

RA is when the immune system attacks___________

Answer 4

the synovial lining of joints

Question 5

when inflammation thickens the synovium and destroys joint, its called ________

Answer 5

pannus formation

Question 6

what are labs/tests for RA

Answer 6

arthrocentesis
CT
CBC, ESR, CRP, rheumatoid factor (inflamm)

Question 7

what meds are avoided in RA?

Answer 7

opioids

Question 8

what meds are used for RA

Answer 8

-DMARDS (disease modifying anti-rheumatic drugs)
-NSAIDS (ibuprofen/naproxen)
-cox-2 (celecoxib)
-corticosteroids (prednisone)

Question 9

complications of RA

Answer 9

-CVD
-med toxicity
-damage to skin/eyes/vessels/heart etc.
-deformity of hands/feet

Question 10

goals of RA treatment

Answer 10

-decrease pain / swelling, prevent joint damage, minimize disability

Question 11

what is involved in RA treatment

Answer 11

exercise, nonpharm methods, tai chi yoga, complimentary alternative medicine

Question 12

what is noninflammatory joint destruction and is an end result of an autoimmune disorder

Answer 12

osteoarthritis

Question 13

what is osteoarthritis caused by

Answer 13

obesity, laborous occupation, genetics

Question 14

what condition has breakdown of articular cartilage, progressive damage to bone, narrowing of joint space, joint movement limited, pain/damage, progressive joint damage

Answer 14

osteoarthritis

Question 15

what is osteoarthritis aggravated and relieved by?

Answer 15

aggravate = movement/exercise
relieve = rest

Question 16

lab/tests for OA

Answer 16

xray/MRI
blood test to r/o RA

Question 17

meds that can help OA

Answer 17

NSAIDS
cox-2 (celecoxib)
intra-articular corticosteroids
acetaminophen
diclofenac
glucosamine / chondroitin

Question 18

complications of osteoarthritis

Answer 18

-depression / sleep disturbances
-difficulty with ADLs
-need for arthroplasty

Question 19

how can nurses help OA

Answer 19

exercise/strength training
weight loss
OT/PT
splints/braces
CAM therapy
heat/cold

Question 20

what are causes of gout?

Answer 20

-high uric acid in blood
-age, BMI
-HTN meds
-thiazide diuretics

Question 21

what causes high uric acid in blood

Answer 21

-fructose beverages
-alcohol (beer)

Question 22

what happens in gout?

Answer 22

-hyperuricemia
-macrophages crystallize (sharp/painful)
-deposits in peripheral area

Question 23

how will a client with gout present?

Answer 23

-arthritis
-sudden pain
-pain, swelling, tender
-limited ROM

Question 24

labs/tests for gout

Answer 24

joint fluid analysis
xray

Question 25

what meds help acute gout attacks

Answer 25

colchicine NSAIDs corticosteroids

Question 26

meds for management of gout

Answer 26

xanthines (allopurinol) uricosurics (probenecid)

Question 27

what are complications of gout

Answer 27

-tophi (nodules) -kidney stones

Question 28

how can nurses help gout pts?

Answer 28

-foods low in purines (organ meat) -have coffee, vit. C, and cherries -lifestyle change -weight loss -decrease alcohol -med compliance

Question 29

what is amplified pain d/t CNS abnormally amplifying pain signals

Answer 29

fibromyalgia

Question 30

what are causes of fibromyalgia?

Answer 30

unknown

Question 31

what triggers fibromyalgia

Answer 31

genetics, anxiety, depression, trauma

Question 32

how will a client with fibromyalgia present?

Answer 32

-widespread pain -fatigue

Question 33

what labs/tests are for finromyalgia

Answer 33

none

Question 34

what meds help fibromyalgia

Answer 34

NOT OPIOIDS -NSAIDS -TCAs!!! -SNRIs/SSRIs!! -muscle relaxants

Question 35

how can nurses help fibromyalgia?

Answer 35

CAM/exercise CBT sleep hygeine support group stress reduction