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. Guillain-Barre Syndrome is not a contagious disease. It is an autoimmune disorder that occurs when the immune system mistakenly attacks the peripheral nerves. GBS is not spread through respiratory droplets or any other form of infection transmission.
B. Guillain-Barre Syndrome causes demyelination in the peripheral nervous system, not the central nervous system. The central nervous system includes the brain and spinal cord, whereas the peripheral nervous system comprises the nerves outside the brain and spinal cord.
C. Guillain-Barre Syndrome is not a genetic disorder. It is considered an autoimmune condition that can be triggered by an infection or other environmental factors. While there may be genetic predispositions that affect susceptibility to autoimmune conditions, GBS itself is not classified as a genetic disorder.
D. Guillain-Barre Syndrome primarily affects the peripheral nervous system. It involves an immune- mediated attack on the peripheral nerves, leading to symptoms such as muscle weakness, tingling, and loss of reflexes.

A. Bleeding of the gums after oral care. B. Hemoglobin of 14 g/dL. C. Tachycardia and shortness of breath. D. Petechiae on the oral mucosa.

Correct Answer is C

Explanation

A. Gum bleeding can be a sign of thrombocytopenia (low platelet count) and is concerning because it indicates a potential for bleeding complications. However, while it's significant, it might not be the most urgent symptom in the context of HIT compared to symptoms indicating acute thrombosis.

B. A hemoglobin level of 14 g/dL is generally within the normal range for most adults. In the context of HIT, this level does not indicate any immediate abnormality or severe issue related to anemia or bleeding, making it less concerning compared to other symptoms that might indicate acute complications.
C. Tachycardia (increased heart rate) and shortness of breath are concerning symptoms in the context of HIT. These symptoms can be indicative of a thrombotic event such as a pulmonary embolism (PE) or deep vein thrombosis (DVT), which are serious complications of HIT. The presence of these symptoms requires urgent evaluation as they suggest possible life-threatening complications.
D. Petechiae are small, pinpoint red or purple spots that appear due to bleeding under the skin, often associated with low platelet counts. While petechiae are a concerning sign and indicate bleeding issues, the presence of tachycardia and shortness of breath generally represents a more immediate threat to the patient's life due to potential thromboembolic events.

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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.)

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Naxlex Comprehensive Predictor Exams

A nurse educator is providing an educational in-service about various neurological disorders. Which statement should be included when teaching about Guillain-Barre Syndrome?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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