Unit 1 Flashcards
Labs used to diagnose Rheumatoid arthritis
ESR
Rheumatoid factor
Platelet
Patients with rheumtoid arthritis should plan for _______ in the morning and it can last __________
morning stiffness
30 mins
Medical management for Rheumatoid arthritis
ROM exercises, PT/OT, Aerobic exercises, proper nutrition, balance rest and activity
Medications used to manage Rheumatoid Arthritis
Glucocorticoid, NSAIDs, DMARD’s, Analgesics
What labs should be monitored when on a medication regimin for Rheumatoid arthritis?
Platelets, BUN, Creatinine
Priority Nursing diagnosis for rheumatoid arthritis
Joint pain (PQRST)
Mobility
Temp
Monitor labs
This medication classification is used to treat RA and can be given PO, IM, IV. It supresses inflammation. Pt’s taking this should have their blood sugar monitored, electrolytes( mainly potassium), CBC (hgb), needs to be taken at the same time each day and cannot be stopped suddenly
Glucocorticoid
This medication classification is given PO, for RA. can help with pain relief and decrease inflammation. pt’s taking this med should be taught to monitor for S/S of bleeding, not to take medication with alcohol, and that this medication can increase clotting times
NSAIDs
patient teaching with glucocorticoids
can cause insomnia
can decrease wound healing
can cause moon face
can cause weight gain
can cause fluid retention
patient teaching with NSAIDs
constipation
nausea
liver involvement
avoid alcohol
Assess for GI bleed
This medication classification can be given PO, SQ, IM, IV and is given to treat RA. It alters the inflammatory response, decreases inflammation, and slows disease progression. Patients should be monitored for bleeding, they shouldn’t be given any IM injections, and their CBC should be monitored.
DMARD’s
patient teaching for DMARD’s
Assess for S/S of bleeding
no IM injections
monitor CBC
Bleeding gums
bruising
petechiae
black tarry stools
these are all s/s of what?
bleeding
Rabies
polio
flu
hepatitis A
these are all examples of what type of vaccines
inactivated vaccines
Measles, Mumps, and rubella (MMR)
Rotavirus
smallpox
chicken pox
yellow fever
are all examples of what types of vaccines
live
When a DMARD is given IV it can cause what?
vein sensitivity
What type of chair should a person with RA sit in if they have deformities?
a chair with a straight and high back
If on immunosuppressive therapy and you have an active infection what should you do?
stop the immunosuppressive agent and contact PCP
Teaching points for RA patients
Adherence to treatment plan
Report s/s of infection
keep current on vaccinations
assist with referrals
ID safety hazards at home
proper use of assistive devices
energy conservation techniques
encourage consistent exercise program
Importance of follow up appointments
sit in high straigh back chair
Complications with RA
decreased function
permanent joint deformities
infection
cancer
RA patients are at an increased risk of developing what d/t the chronic inflammation
cancer
unprotected sex
IV drug use
blood transfusions
occupational exposure
Pregnant/breastfeeding women
older population
are all risk factors for what?
HIV/AIDS
fever
cough
weakness
nausea/vomiting
diarrhea
dysphagia
forgetfulness
skin lesions
ShOB, DOE
headache
vision changes
night sweats
lymphadenopathy
these are all clinical manifestations of what?
HIV/AIDS
A client expresses concern about being exposed to HIV/AIDS what should be done?
- A thorough physical assessment to determine any clinical manifestations, obtain a sexual history, and have them describe any high-risk behaviors that would indicate viral transmission has occurred.
persistent cough lasting more than 3 weeks
bloody sputum
weight loss
night sweats
high temperature
tired or fatigued
loss of appetite
swellings that haven’t gone away after few weeks
are all S/S of what?
TB
List the S/S of TB
persistent cough lasting more than 3 weeks
bloody sputum
weight loss
night sweats
high temperature
tired or fatigued
loss of appetite
swellings that haven’t gone away after few weeks
Diagnostic testing for HIV/AIDS
ELSIA and HIV VIrus Antibodies
Maintenance labs for someone who has HIV/AIDS and is receiving drug therapy
CD4+, Viral load
What is the relationship between the CD4+ and the viral load?
as CD4+ increases viral load decreases
Vital signs to monitor for HIV/AIDS
Temp ^
pulse
resp
o2
What would be a concern when assessing a HIV/AIDS GI system
difficulty swallowing
N/V/D
Weight loss
What would be a concern when monitoring an HIV/AIDS pt’s neuro system
LOC
Mental status
memory recall
headache
vision changes
What to would be a concern when assessing a HIV/AIDS patients respiratory system
ShOB or DOE
Presence of cough
color of sputum
S/S of TB
Nursing interventions for an HIV/AIDS patient
Universal precautions
monitor for S/S of infection
Administer ART as prescribed and on time
Nutritionally dense foods & small frequent meals
Provide respiratory support
Provide emotional support
Administer IV fluids as ordered
Provide meticulous skin care
Swollen and painful lymph glands (neck, axillae, groin, LUQ)
Increased infections - causing neutropenia (low grade fever in response to minor infections)
Anemia (fatigue, pallor, weakness, ShOB)
Bleeding (bruising, petechiae, nosebleeds, bleeding gums)
are all s/s of what?
Leukemia
List s/s of Leukemia
Swollen and painful lymph glands (neck, axillae, groin, LUQ)
Increased infections - causing neutropenia (low grade fever in response to minor infections)
Anemia (fatigue, pallor, weakness, ShOB)
Bleeding (bruising, petechiae, nosebleeds, bleeding gums)
leukemia nursing assessment
Vital SIgns:
^ temp
^resp
^HR
Respiratory:
ShOB
Integumentary:
Pallor
Bruising, patechiae
MS:
fatigue
Sensory:
dizziness
Immune system:
swollen lymph nodes
GI:
Anorexia
Bleeding gums
Rectal bleeding
Treatment for leukemia
chemotherapy
radiation
blood/blood products
granulocyte colony-stimulating factors
bone marrow transplant
A leukemia treatment that destroys cells
chemotherapy
A therapy that kills cancer cells or slows growth by damaging their DNA
Radiation therapy
Describe chemotherapy
A leukemia treatment that destroys cells
describe Radiation therapy
A therapy that kills cancer cells or slows growth by damaging their DNA
a supportive care measure for leukemia, used to care for low RBC and Plt count
Blood/product transfusions
Describe Blood/product transfusions
a supportive care measure for leukemia, used to care for low RBC and Plt count
Describe granulocyte colony-stimulating factors (GCSFS)
supportive care for neutropenia to prevent post-chemo infections
what is a supportive care for neutropenia to prevent post-chemo infections
Describe granulocyte colony-stimulating factors (GCSFS)
Describe a Bone Marrow/Stem cell transplant
curative treatment used for leukemia that replaces unhealthy marrow/cells with healthy ones
What is a curative treatment used for leukemia that replaces unhealthy marrow/cells with healthy ones
Bone marrow/stem cell transplant
this medication is given to leukemia patients, it kills or inhibits the reproduction of cancer cells. It can kill normal healthy cells. Dosing based on total body surface area
Antineoplastic meds
desribe Antineoplastic meds
this medication is given to leukemia patients, it kills or inhibits the reproduction of cancer cells. It can kill normal healthy cells. Dosing based on total body surface area
List side effects of antineoplastic medications
Mucositis
Alopecia
anorexia N/V
Diarrhea
Anemia
Neutropenia
THrombocytopenia
Infertility
Neuropathy
Gout
Mucositis
Alopecia
anorexia N/V
Diarrhea
Anemia
Neutropenia
THrombocytopenia
Infetility
Neuropathy
Gout
are all side effects of what medication class?
antineoplastic medications
Nursing implications for antineoplastic medications
Monitor for anaphylaxis
Monitor labs: CBC, WBC, Plt, uric acid, electrolytes
Bleeding precautions
If neutropenic stop medication
Initiate neutropenic precautions
Monitor S/S of infection
encourage hydration 2000 mL
Antiemetics as ordered
what does body surface area include?
current weight, current height
What is mucositis
mouth or gut is sore and inflamed, usually pretty painful