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A nurse is planning care for a client who has rheumatoid arthritis and has moderate to severe pain in multiple joints. Which of the following actions should the nurse plan to take?

Perform ADLs for the client to promote rest

Allow for frequent rest periods throughout the day

Use heat to reduce joint inflammation

Develop a daily schedule for acetaminophen up to 6 g/day that covers peak periods of pain

Answer and Explanation

The Correct Answer is B

Allow for frequent rest periods throughout the day.

A. Perform ADLs for the client to promote rest. This is incorrect because performing ADLs for the client can increase their dependence and decrease their self-esteem. The nurse should encourage the client to perform ADLs as much as possible, with assistance as needed, to maintain their function and mobility.
B. Allow for frequent rest periods throughout the day. This is correct because rest periods can help reduce fatigue and pain, as well as prevent joint damage and inflammation. The nurse should balance rest and activity for the client and avoid overexertion.
C. Use heat to reduce joint inflammation. This is incorrect because heat can increase inflammation and pain in acute rheumatoid arthritis. The nurse should use cold applications to reduce swelling and inflammation in acute episodes, and use heat for chronic stiffness and pain. - D. Develop a daily schedule for acetaminophen up to 6 g/day that covers peak periods of pain. This is incorrect because acetaminophen has a maximum daily dose of 4 g/day, and exceeding this dose can cause liver toxicity. The nurse should monitor the client's liver function and use other analgesics as prescribed.

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Correct Answer is C

Explanation

Choice A rationale:

Administering terbutaline is used to stop or slow down preterm labor contractions. In the given scenario, the client is in the latent phase of labor and is experiencing severe back pain. Terbutaline is not indicated for back pain during labor.

Choice B rationale:

Placing the client in a warm bath can provide comfort and relaxation, but it may not specifically alleviate back pain during labor. Additionally, warm baths are more commonly used for pain relief in early labor or during the active phase, not specifically for back pain.

Choice C rationale:

Applying counterpressure during each contraction is an appropriate intervention for relieving back pain during labor. Back pain is a common discomfort experienced by many women during labor, and counterpressure, often applied by a support person or nurse, can help alleviate the discomfort. It is a non-pharmacological method that can be effective in managing pain during labor.

Choice D rationale:

Requesting the provider prescribe a pudendal nerve block is not the first-line intervention for back pain during labor. Pudendal nerve blocks are used for pain relief during the second stage of labor (during delivery) and are typically administered by the provider if needed. It is not the appropriate intervention for back pain in the latent phase of labor.

A. "Have you experienced muscle stiffness?" B. "Have you had any stomach pain or bloody stools?" C. "Have you experienced a dry cough?" D. "Have you noticed an increase in urine output?"

Correct Answer is B

Explanation

"Have you had any stomach pain or bloody stools?"

Rationale:

A. Muscle stiffness is not a common or serious adverse effect of ibuprofen. Ibuprofen is an antiinflammatory drug that can reduce pain and stiffness caused by arthritis.
B. Stomach pain or bloody stools are signs of gastrointestinal bleeding, which is a serious and potentially fatal adverse effect of ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause ulceration, perforation, and hemorrhage of the stomach or intestines . The nurse should ask the client about any gastrointestinal symptoms and advise them to avoid alcohol, smoking, and other NSAIDs while taking ibuprofen.
C. Dry cough is not a common or serious adverse effect of ibuprofen. Dry cough is more likely to be caused by angiotensin-converting enzyme (ACE) inhibitors, which are used to treat hypertension and heart failure.
D. Increase in urine output is not a common or serious adverse effect of ibuprofen. Ibuprofen can cause renal impairment, which can lead to decreased urine output, not increased urine output. The nurse should monitor the client's renal function tests and fluid balance while taking ibuprofen.

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A nurse is planning care for a client who has rheumatoid arthritis and has moderate to severe pain in multiple joints. Which of the following actions should the nurse plan to take?

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