A nurse is teaching a client who has rheumatoid arthritis about illness management.

Which of the following instructions should the nurse include in the teaching?

Apply cold packs directly on the skin of the affected joints.

Administer biological response modifiers to prevent infection

Take a hot shower in the morning to decrease stiffness.

Cluster physical activities during the day

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Taking a hot shower in the morning can help decrease stiffness and improve joint mobility for people with rheumatoid arthritis. This is one of the self-management strategies that can reduce pain and disability.

Choice A is wrong because applying cold packs directly on the skin of the affected joints can cause vasoconstriction and increase inflammation.

Cold therapy should be used with caution and with a barrier between the skin and the ice pack.

Choice B is wrong because biological response modifiers are not used to prevent infection, but to reduce inflammation and slow down joint damage in rheumatoid arthritis.

These medications can actually increase the risk of infection by suppressing the immune system.

Choice D is wrong because clustering physical activities during the day can cause fatigue and joint stress for people with rheumatoid arthritis.

It is better to pace activities throughout the day and take frequent breaks to rest the joints.

Normal ranges for rheumatoid arthritis are based on the disease activity score (DAS), which measures the number of swollen and tender joints, the level of inflammation in the blood, and the patient’s global assessment of health. A DAS below 2.6 indicates remission, a DAS between 2.6 and 3.2 indicates low disease activity, a DAS between 3.2 and 5.1 indicates moderate disease activity, and a DAS above 5.1 indicates high disease activity.

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Correct Answer is D

Explanation

The correct answer is choice D. Place a wedge under one of the client’s hips. This is because placing a wedge under one of the hips can help prevent compression of the inferior vena cava by the uterus, which can compromise placental blood flow and cause fetal hypoxia. Placing a wedge under the hip can also help reduce the risk of maternal hypotension, which can also affect fetal oxygenation.

Choice A is wrong because inserting a pillow under the client’s knees can increase the risk of thromboembolism, which is a potential complication of cesarean birth.

Choice B is wrong because positioning the client in reverse Trendelenburg can increase the risk of maternal aspiration, which is another potential complication of cesarean birth.

Choice C is wrong because assisting the client into the lithotomy position can also compress the inferior vena cava and reduce placental blood flow. The lithotomy position is also not necessary for cesarean birth, as the baby is delivered through an incision in the abdomen and uterus.

A. Give cromolyn nebulized solution every 6 hr. B. Offer small amounts of clear liquids 6 hr following surgery. C. Apply a warm compress to the operative site once daily. D. Administer analgesics on a scheduled basis for the first 24 hr.

Correct Answer is D

Explanation

The correct answer is choice D. Administer analgesics on a scheduled basis for the first 24 hr.

This is because the child is at risk for developing peritonitis, which can cause severe abdominal pain.

Scheduled analgesics can provide better pain relief than PRN analgesics.

Choice A is wrong because the child should not be given anything by mouth until bowel sounds return, which can take up to 24 hr after surgery.

Giving clear liquids too soon can cause nausea, vomiting, and abdominal distension.

Choice B is wrong because cromolyn nebulized solution is used to prevent asthma attacks, not to treat appendicitis.

There is no indication that the child has asthma or needs this medication.

Choice C is wrong because applying a warm compress to the operative site can increase inflammation and infection risk.

A cold compress can be used to reduce swelling and pain, but only if prescribed by the provider.

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A nurse is teaching a client who has rheumatoid arthritis about illness management. Which of the following instructions should the nurse include in the teaching?

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A nurse is teaching a client who has rheumatoid arthritis about illness management.

Which of the following instructions should the nurse include in the teaching?