front 1 what part of the hand is spared by rheumatoid arthritis | back 1 distal interphalangeal joints (close to fingernail) |
front 2 which age group is affected by rheumatoid arthritis | back 2 35-45 years old |
front 3 which age group is affected by osteoarthritis | back 3 60 and older |
front 4 what condition affects weight bearing joints, hands and the spine | back 4 osteoarthritis |
front 5 what part of the hand is spared from osteoarthritis | back 5 metacarpophalangeal joints (the knuckles) |
front 6 bone and cartilage floating in the joint space is associated with which condition | back 6 osteoarthritis |
front 7 what are primary causes of osteoarthritis | back 7 aging, genetic factors, weight bearing/overuse |
front 8 what are secondary causes of osteoarthritis | back 8 joint injury, joint overuse, obesity, other joint diseases (rheumatoid arthritis) |
front 9 heberden nodules is located on which part of the hand | back 9 distal interphalangeal joint (DIP) |
front 10 bouchard nodules is located on which part of the hand | back 10 proximal interphalangeal joints (PIP) |
front 11 persistent joint pain, stiffness and crepitus is associated with which condition | back 11 osteoarthritis |
front 12 what happens when a patient with osteoarthritis is inactive | back 12 stiffness follows inactivity for less than 30 minutes |
front 13 what is a telltale sign of osteoarthritis | back 13 swelling in the hands from herberden and bouchard nodules |
front 14 what is the first line drug for persistent pain for osteoarthritis | back 14 acetaminophen |
front 15 who is more at risk of liver damage while taking acetaminophen | back 15 a patient who is an alcoholic or liver disease |
front 16 what would you teach a patient in regards to taking acetaminophen | back 16 teach them to read OTCD to see if acetaminophen is an ingredient |
front 17 what is the next first line drug after acetaminophen | back 17 lidocaine 5% patch |
front 18 how many patches of lidocaine can you apply to a painful joint at one time | back 18 3 patches |
front 19 what will you teach the patient about lidocaine patch | back 19 apply to clean intact skin 12hrs/day |
front 20 lidocaine 5% patch is contraindicated in which patient? | back 20 a patient taking antidysrhythmic drugs |
front 21 second line drugs for persistent pain in osteoarthritis | back 21 celecoxib and diclofenac patch |
front 22 what are the side effects of the diclofenac patch | back 22 it can cause cardiovascular and GI effects |
front 23 celecoxib is contraindicated in a patient with | back 23 hypertension, kidney disease or CVD |
front 24 with long term use of celecoxib what effect can happen | back 24 bleeding and acute kidney injury |
front 25 vasoconstriction and platelet clumbing by the use of celecoxib can cause which conditions | back 25 hypertension and MI |
front 26 what will you have the patient report if using celecoxib | back 26 dark tarry stools, SOB, edema, dyspepsia, hematesis, change in UO |
front 27 if first and second line of drugs do not work for a patient with osteoarthritis you would administer what next? | back 27 tramadol (opioid) |
front 28 tramadol can cause what in an older adult? | back 28 confusion |
front 29 the nurse will teach the patient what when using tramadol? | back 29 do not drive or operate heavy machinery |
front 30 patients may turn to OTC drugs and supplements for their pain such as | back 30 topical capsaicin, glucosamine, chondroitin |
front 31 patient teaching for the use of topical capsaicin is | back 31 the med can cause burning sensation, use gloves and wash hands |
front 32 if you want to strengthen cartilage using OTC/supplement you will use which drug? | back 32 chondroitin |
front 33 if you want to decrease inflammation using OTC/supplement you will use which drug? | back 33 glucosamine |
front 34 what will you teach the patients about nonpharmacological pain management | back 34 don't sleep with pillows under the knees, insoles in shoes, proper posture when sitting/standing |
front 35 contraindications for surgical management is | back 35 progressive inflammation or infection anywhere in the body |
front 36 what two things will you control preoperatively before THA/TKA | back 36 BP and glucose |
front 37 decreased soft tissue damage, decreased blood loss and decreased post op pain and length of hospital stay is because the surgeon used which surgical technique? | back 37 minimally invasive surgery |
front 38 after surgery for THA the nurse will conduct what post op | back 38 neurovascular assessment |
front 39 to prevent dislocation after THA the nurse will have the patient use a | back 39 abduction pillow |
front 40 the patient undergone a THA, the patient cannot communicate but is showing signs of agitation the nurse should recognize this as a possible? | back 40 hip dislocaiton |
front 41 what are signs of hip dislocation? | back 41 pain, shortening leg, affected leg rotation |
front 42 which patients are allowed immediate total weight bearing as tolerated? | back 42 those with cemented implants |
front 43 which patients are told minimal weight bearing until bony ingrowth is shown on an xray? | back 43 those with non cemented implants |
front 44 when can a patient transition to a single crutch or cane? | back 44 4-6 weeks post op if no severe limp |
front 45 you teach your patient to call 911 when what happens? | back 45 hip dislocation, acute chest pain or SOB |
front 46 patients with a total knee replacement will receive what pre operately? | back 46 nasal mupirocin daily x1 week |
front 47 what is a normal finding after a TKA | back 47 swollen discolored knee |
front 48 for young patients undergoing surgery which drug can be effective in treating their pain? | back 48 IV acetaminophen |
front 49 what is not a complication of TKA? | back 49 dislocation |
front 50 a patient has restricted joint motion and decreased functional ability due to which condition after their TKA? | back 50 arthrofibrosis |
front 51 what exercises should you avoid in osteoarthritis when severely inflamed? | back 51 resistive exercises |
front 52 what forms in the joint space of rheumatoid arthritis? | back 52 pannus |
front 53 a patient has developed vasculitis, the nurse knows the patient is at risk for what? | back 53 organ damage |
front 54 your patient has lost some weight, complains of feeling weak and very fatigued. you check their temperature and they have a low grade fever and they tell you they occasionally wake up stiff in the morning. the nurse knows these are signs of? | back 54 early rheumatoid arthritis |
front 55 a patient comes in with brown spots around their nail bed, the nurse knows this is a sign of? | back 55 vasculitis |
front 56 your patient has osteoporosis, severe fatigue and pain, joint deformities and rheumatoid nodules. these sx are consistent with | back 56 advanced rheumatoid arthritis |
front 57 in advanced rheumatoid arthritis what does the joints of your patient feel like? | back 57 soft and puffy |
front 58 which nodules can appear and disappear? | back 58 rheumatoid nodules |
front 59 life threatening condition that can happen with RA is? | back 59 subluxation |
front 60 what will you expect to see with the synovial fluid after an arthrocentesis is performed if the patient has RA? | back 60 cloudy increased volume, with increased WBC |
front 61 you wont give celecoxib to which patient? | back 61 one who had open heart surgery |
front 62 celecoxib has a high risk for what? | back 62 GI bleeding |
front 63 for a patient with RA taking NSAIDs for their chronic inflammation and persistent pain, they must take their NSAIDs with? | back 63 H2 blocker (famotidine) |
front 64 the patient has been prescribed methotrexate and been on it for 2 weeks. they claim they still have not seen an improvement. the nurse should make which statement? | back 64 this drug takes 4-6 weeks to impact joint inflammation |
front 65 a patient taking methotrexate, what should a nurse look our for with this patient? | back 65 signs of infection |
front 66 a patient comes in with bruising and bleeding, labs show they have low platelets. the nurse knows this is because they are taking? | back 66 methotrexate which causes thrombocytopenia |
front 67 a woman is taking methotrexate, you teach her to have another contraception method because? | back 67 methotrexate can cause birth defects |
front 68 how many months should a women stop taking methotrexate before trying for pregnancy? | back 68 3 months |
front 69 you can lessen the side effects of methotrexate if it taking with what? | back 69 folate |
front 70 a patient comes in with pneumonitis, they have dyspnea and are complaining about sores in their mouth. labs came back and shows LFT and creatinine elevations. the nurse knows these are sx of which drug? | back 70 methotrexate |
front 71 hair loss, diarrhea, birth defects, leukocytopenia, and thrombocytopenia are adverse effects of which drug? | back 71 leflunomide |
front 72 how long does is take to get the max benefit of leflunomide? | back 72 4-6 weeks up to 3 months |
front 73 light headedness, stomach discomfort and headaches are consistent with which drug? | back 73 hydroxychloroquine |
front 74 hydroxychloroquine is contraindicated in which patients? | back 74 those with cardiac diseases and dysrhythmias |
front 75 a patient comes into the clinic complaining of blurred vision, and a headache. the nurse knows this is a serious side effect of? | back 75 retinal damage caused by hydroxychloroquine use |
front 76 a nurse is teaching a patient about side effects of sulfasalazine, the nurse tells the patient it can cause | back 76 nausea, vomiting and a skin rash |
front 77 abatacept, etanercept, infliximab, rituximab can cause a patient to be high risk for what? | back 77 impaired immunity |
front 78 due to the impaired immunity from abatacept the patient should be informed to refrain from getting what? | back 78 live vaccinations |
front 79 abatacept or infliximab is contraindicated in patients with which conditions? | back 79 infections, MS or pos PPD |
front 80 teaching for a patient taking infliximab would be? | back 80 avoid large crows and ppl with infections |
front 81 glucocorticoids like prednisone and cortisone can cause which conditions? | back 81 diabetes, HTN, osteoporosis, glaucoma, adrenal insufficiency and F&E imbalace |
front 82 the patient undergone a procedure that cleaned their plasma of antibodies from their blood and got it reinfused into their body. this procedure is called? | back 82 plasmapheresis |