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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["50"]
Explanation
Flow rate in gtt/min = (Volume in mL * Drop factor) / Time in minutes.
The prescribed volume is 150 mL/hr. Since there are 60 minutes in an hour, the time for one hour would be 60 minutes. The drop factor is 20 gtt/mL.
(150 mL/hr * 20 gtt/mL) / 60 min/hr = 3000 gtt/hr / 60 min/hr = 50 gtt/min.
Therefore, the nurse should set the manual IV infusion to deliver 50 gtt/min.
Correct Answer is ["C","E"]
Explanation
Muscle hypertrophy (increase in muscle size) is not a typical manifestation of ALS. In fact, ALS leads to muscle atrophy (wasting) rather than hypertrophy. As motor neurons degenerate, muscles become weaker and smaller because they are no longer receiving adequate nerve signals to maintain strength.
B.A Tinnitus (ringing in the ears) is not a common manifestation of ALS. ALS primarily affects motor neurons and does not usually cause auditory symptoms. Tinnitus is more related to other conditions such as ear infections, exposure to loud noises, or certain neurological conditions, but it is not associated with ALS.
C. Tripping or stumbling is a common manifestation of ALS. As the disease progresses, it causes weakness in the muscles responsible for maintaining balance and coordination. This can lead to difficulties with walking and increased risk of tripping or falling.
D. Confusion is not a typical symptom of ALS. ALS primarily affects motor neurons, leading to muscle weakness and atrophy, but it does not usually affect cognitive function. However, in rare cases, some patients with ALS may develop cognitive or behavioral changes, but these are not the primary symptoms and are less common.
E. Dropping objects is a common manifestation of ALS. Muscle weakness and loss of fine motor control in the hands and arms can make it difficult to hold or manipulate objects, leading to frequent dropping.
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