A client is admitted to the hospital during an exacerbation of rheumatoid arthritis (RA). Which of the following nursing interventions are appropriate for a client experiencing an RA flare? (Select all that apply.)

Place client on total bedrest and avoid use of affected joints

Provide warm compresses to affected joints

Place several pillows under the head to keep the neck in a flexed position

Place the client on continuous cardiac monitoring

Administer methylprednisolone as ordered

Answer and Explanation

Correct Answer : B,E

A.   Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B.   Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C.   Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D.   Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E.   Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.

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Correct Answer is D

Explanation

A. MS is an autoimmune disorder affecting the central nervous system, not the kidneys.
B. MG is an autoimmune disorder affecting the neuromuscular junction, not the kidneys.
C. GBS is an autoimmune disorder affecting the peripheral nervous system, not the kidneys.
D. SLE is a systemic autoimmune disorder that can affect multiple organs, including the kidneys. Glomerulonephritis is a common complication of SLE.

A. Methylprednisolone B. Enoxaparin C. Pantoprazole D. Ibuprofen

Correct Answer is C

Explanation

A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

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A client is admitted to the hospital during an exacerbation of rheumatoid arthritis (RA). Which of the following nursing interventions are appropriate for a client experiencing an RA flare? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has inflammation of the glomeruli which was discovered by a routine urinalysis. The nurse understands that which of the following autoimmune disorders can cause chronic glomerulonephritis?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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