A nurse is caring for a child who has juvenile rheumatoid arthritis. Which of the following actions should the nurse take?
Maintain night splints to the affected joint.
Encourage the child to take daytime naps.
Administer opioids on a schedule.
Apply cool compresses for 20 min every hour.
The Correct Answer is A
A. Maintain night splints to the affected joint: Night splints help maintain joint position and function during sleep, preventing contractures and deformities. This is a common intervention in managing juvenile rheumatoid arthritis to ensure proper joint alignment and minimize pain and stiffness.
B. Encourage the child to take daytime naps: Daytime naps can lead to prolonged periods of immobility, which may increase stiffness and pain in joints. Maintaining regular activity and exercise is usually recommended to preserve joint function.
C. Administer opioids on a schedule: Opioids are not typically first-line treatment for juvenile rheumatoid arthritis due to potential side effects and risk of dependence. Nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) are more commonly used.
D. Apply cool compresses for 20 min every hour: Cool compresses may provide temporary relief for acute joint pain but are not recommended on a regular schedule due to risk of skin damage and reduced joint flexibility. Heat application is more commonly used for chronic pain relief in arthritis.
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Related Questions
Correct Answer is C
Explanation
A. Absent plantar reflexes: This is not typically associated with DDH. DDH affects the hip joint's formation, not reflexes.
B. Inwardly turned foot on the affected side: This finding is more indicative of conditions like clubfoot, not DDH.
C. Asymmetric thigh folds: This is a common finding in DDH. The folds may appear uneven due to the displacement of the femoral head.
D. Lengthened thigh on the affected side: In DDH, the thigh on the affected side may actually appear shorter, not longer, due to hip dislocation.
Correct Answer is D
Explanation
A. "My parents treat me like a baby sometimes." This statement reflects a common adolescent feeling of striving for independence and experiencing frustration when treated as a child. It is a normal part of adolescent development and not a cause for immediate concern.
B. "There's a pimple on my face, and I worry that everyone will notice it." Concern about appearance is typical for adolescents due to the increased focus on body image and peer perception. This statement is a normal expression of adolescent self-consciousness.
C. ``I start taking ibuprofen a few days before my period starts." Using ibuprofen preemptively for menstrual cramps is a reasonable self-care practice for adolescents experiencing menstrual discomfort. This statement does not indicate any immediate health concern.
D. "None of the kids at my school like me, and I don't like them either." This statement indicates social isolation and potential issues with peer relationships, which can be a red flag for emotional distress or depression. It may suggest that the adolescent is experiencing significant difficulties in their social life that could lead to more serious mental health concerns.
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