Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 239 > Test #3: Musculoskeletal > Flashcards

Test #3: Musculoskeletal Flashcards

1
Q

What is arthritis?

A

inflammation of a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would be present in stage 1 of Rheumatoid Arthritis?

A

No destructive changes on x-ray; possibly evidence of osteoporosis of x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is subluxation?

A

Incomplete or partial dislocation of a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does a elevated “sed rate” (ESR) lab result indicate?

A

Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 most common manifestations of rheumatoid arthritis?

A

Rheumatoid nodules, Sjogren’s syndrome and Felty syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 typical deformities of RA?

A

Ulnar drift, Boutonniere deformity, Hallus valgus and swan neck deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the “ulnar drift”?

A

Fingers shifting, over time, away from the thumb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is “Boutonniere’s deformities”?

A

Condition where the knuckle will not fully extend; it keeps the finger from ever completely straightening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Hallux valgus?

A

Also called a “bunion”; big toe deviates to the side (point hard towards the other toes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the “swan neck” deformity?

A

Where the knuckle almost hyperextends and distal knuckle stays bent, creating a “swan neck” appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a side effect of Methotrexate?

A

Bone marrow supression and hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a notable side effect of Anti-Malarial drugs?

A

Vision effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long does taking Gold (Ridaura) take to build to therapeutic levels?

A

3-4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long should you apply hot/warm pack?

A

No more than 20 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long should you apply cold/ice packs?

A

No more than 10-15 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What teaching would need to be given to a patient who has been prescribed immunosuppressants?

A

Avoid crowds and sick people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are risk factors for gout?

A

Obesity, Hypertension, using diuretics, excessive alcohol intake and purine-rich diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What tests indicate gout?

A

Uric acid (level about 6), 24-hour uric acid level, synovial fluid aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The diagnosis of gout is normally based on what?

A

80% are simply based on clinical symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are acute gout flare-ups treated?

A

With Colchicine and NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What drug is given for chronic gout?

A

Allopurinol or Febuxostat (Uloric)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the two specific manifestations of SLE?

A

Butterfly rash and photo sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the patho of gout?

A

Overproduction or impaired excretion of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of drug is Colchizine?

A

An anti-inflammatory used to treat acute gout “flare-ups”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a “Uricosuric”?

A

Uricosuric is the class of drugs that increase the amount of uric acid excreted in urine (thus lowering the amount in circulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is a xanthine oxidase inhibitor?

A

Xanthine oxidase inhibitor is a class of drugs that inhibits xanthine oxidase, an enzyme used in purine metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What drugs, used to control chronic gout, are xanthine oxidase inhibitors?

A

allopurinol (Zyloprim) and febuxostat (Uloric)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What drug should probenecid (Benemid) not be given with?

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Patients that do not respond to traditional therapies for gout may be given what?

A

Corticosteroids or the drug pegloticase (Krystexxa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Patients given medication to excrete more uric acid should be taught to do what?

A

Increase their fluid intake to prevent kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the mechanism of action of probenecid (Benemid)?

A

It inhibits renal tubular absorption of urates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why would probenecid (Benecid) be ineffective for a gout patient?

A

If a patient’s kidney’s are damaged/creatinine clearance is elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A patient with gout should be instructed to make what dietary modifications?

A

Reduce alcohol intake and purine-rich foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What side effects should the patient on corticosteroids be monitored for?

A

Electrolyte imbalance and weight gain

35
Q

The patho of SLE includes..?

A

the production of a variety of autoantibodies directed against components of the cell nucleus

36
Q

In Rheumatoid Arthritis, what process damages the joints?

A

Bony ankylosis and Pannus; bony ankylosis is the joining of bones by extra bone cells, and pannus is highly vascular granulation tissue that forms within the joint and eats away at the cartilage.

37
Q

What signs should a patient, suspected of having scleroderma be assessed for?

A

Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia.

38
Q

What is scleroderma?

A

Scleroderma, is a disorder of connective tissue characterized by fibrotic, degenerative, and occasionally inflammatory changes in the skin, blood vessels, synovium, skeletal muscle, and internal organs.

39
Q

Assessing the hands of a patient with RA, what would the nurse expect to see?

A

Spindle-shaped fingers

40
Q

The pathophysiology of systemic lupus erthematosus (SLE) is characterized by?

A

destruction of nucleic acids and other self-proteins by autoantibodies

41
Q

According to the auto-immune theory, how does rheumatoid arthritis begin?

A

An antigen triggers the formation of an abnormal immunoglobulin. The body then forms auto-antobodies, known as “rheumatoid factor”, against the abnormal immoglobulin and begins an inflammatory response.

42
Q

When caring for a patient with scleroderma, what exercises should the nurse recommend?

A

Mouth excursion and Isometric exercises

43
Q

What medications would be given to a patient with Chronic Fatigue Syndrome?

A

Antihistamines, Antidepressants and NSAIDS

44
Q

What possible complications should a woman of child-bearing-age with SLE be informed of?

A

Stillbirth and spontaneous abortion, Intrauterine growth retardation and overall high risk to mother and baby due to organ involvement

45
Q

What is “calcinosis”?

A

Painful deposits of calcium in the skin

46
Q

What is the acronym that represents the disorders/symptoms of scleroderma?

A

CREST

47
Q

A patient is suffering from scleroderma. Which symptoms suggest the involvement of an internal organ?

A

Dysphagia, Dental caries and Esophageal dysfunction

48
Q

Describe Stage I RA

A

Possible signs of osteoporosis in xray, but no destructive changes

49
Q

Describe Stage II RA

A

Evidence of osteoporosis. Possible nodules and possible slight bone and cartilage damage.

50
Q

Describe Stage III RA

A

Bone and cartilage destruction, and joint deformities (like subluxation, ulnar deviation, or hyperextension) No fibrous or bony ankylosis.

51
Q

Describe Stage IV RA

A

Fibrous or bony ankylosis

52
Q

What foods are high in purines and should be avoided by a patient with gout?

A

Anchovies, Bouillon, Brains, Broth, Consommé, Goose, Gravy, Heart, Herring, Kidney, Mackerel, Meat extracts,
Mincemeat, Mussels, Partridge, Roe, Sardines, Scallops, Sweetbreads and Yeast

53
Q

A patient is diagnosed with scleroderma. What should the nurse anticipate in the pharmacologic treatment plan?

A

Bosentan (Tracleer), Reserpine (Serpasil) and Cyclophosphamide (Cytoxan)

54
Q

A patient just starting gold sodium thiomalate (Myochrysine) therapy for rheumatoid arthritis will need what precautions?

A

Monitoring of hepatic and renal function, rule out pregnancy before starting and teach the patient to immediately report any new rash.

55
Q

What “esophageal dysfunction” is associated with scleroderma?

A

Difficultly swallowing associated with internal scarring

56
Q

What is “sclerodactyly”?

A

Tightening of the skin on the fingers and toes

57
Q

What is “Telangiectasia”?

A

Red spots on the hands, forearms, palms, face and lips

58
Q

What does an increased matrix metallopeptidase (MMP) -3 enzyze indicate?

A

Progressive joint damage

59
Q

A patient with fibromylagia is having trouble sleeping. What medicaton should the nurse recommend?

A

Melatonin (not Benadyrl; it builds tolerance)

60
Q

A 24-year-old female patient with systemic lupus erythematosus (SLE) tells the nurse she wants to have a baby and is considering getting pregnant. Which response by the nurse is most appropriate?

A

Infertility can result from the medications used to control your disease.

61
Q

What is the drug of choice for treating early rheumatoid arthritis?

A

methotrexate (Rheumatrex); it is inexpensive, has a lower toxicity than many other RA drugs and reduces symptoms in days to weeks.

62
Q

What labs should be monitored for s patient taking methotrexate? Why?

A

CBC and Chemistry panel; because methotrexate can cause bone marrow suppression or hepatotoxicity

63
Q

Sulfasalazine and hydroxychloroquine are what class of drugs? Given for what?

A

Antimalarial drugs; given for mild-to-moderate RA

64
Q

What is leflunomide?

A

A synthetic DMARD that blocks immune cell overproduction.

65
Q

What are side effects to leflunomide?

A

Severe liver injury, diarrhea, and teratogenesis.

66
Q

Pregnancy MUST be ruled out before an RA patient can be given what medication?

A

leflunomide

67
Q

To maintain joint motion and muscle strength, a RA pt should be referred for..?

A

Physical therapy

68
Q

What drug is commonly used to treat early RA?

A

Methotrexate

69
Q

What labs should be monitored for the patient on Methotrexate?

A

CBC and Chemistry Panel

70
Q

What anti-malaria drugs are used to treat RA?

A

Sulfasalazine and Hydroxychlorquine

71
Q

What RA drug cannot be given until pregnancy is ruled out?

A

Leflunomide

72
Q

What are the side effects of Leflunomide?

A

Severe liver damage, diarrhea and teratogenesis

73
Q

What RA drugs inhibit tumor necrosis factor from initiating an inflammatory response?

A

Etanercept, Infliximab and Adalimumab

74
Q

What side effect should patients on Etanercept, Infliximab or Adalimumab be monitored for?

A

Infection; they must be taught to report any possible signs

75
Q

What is Anakinra?

A

It is a recombinant version of IL-1 receptor antagonist; it binds to IL-1 and inhibits it from binding to receptors that would start an inflammatory response

76
Q

What drugs can Anakinra be given with?

A

Anakinra can be given with DMARDs but NOT with TNF inhibitors

77
Q

Why can Anakinra not be administered with TNF inhibitors?

A

Giving both together can cause serious infection and neutropenia

78
Q

What drug would be given to patients that do not respond to DMARDs or TNF inhibitors?

A

Abatacept

79
Q

What is Abatacept’s mechanism of action?

A

Abatacept blocks activation of T cells

80
Q

What drugs cannot be given with Abatacept?

A

TNF inhibitors

81
Q

What drug might be used in combination with methotrexate in RA that is not responding to TNF inhibitors?

A

Rituixmab (Rituxan)

82
Q

What new drug might be used for a patient who has not responded or cannot tolerate other RA drugs?

A

Tocilizumab (Actemra)

83
Q

What 5 overall goals would be established for the RA patient?

A

The patient will:

  1. Have satisfactory pain management
  2. Have minimal loss of functional ability of the affected joints
  3. Participate in planning and carrying out the therapeutic regimen
  4. Maintain a positive self-image
  5. Perform self-care to the maximum amount possible

NUR 239 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions