Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
Med serge 2
Autoimmune & Rheumatologic Disorders
1. General Note on Immunosuppressants:
o Treatments suppress the immune system, increasing risk for infection.
o A patient on immunosuppressants with a sore throat is a priority—see them first.
2. Scleroderma:
o Patches appear pale in the center with a purple border.
o Causes hardening of the skin.
o Flares with cold temperatures.
o Often associated with Raynaud’s phenomenon → Keep patient warm.
3. Sjogren’s Syndrome:
o Symptoms: Dry eyes and dry mouth.
o Risk for corneal abrasions (eyes) and gum disease (mouth).
o Dry mouth impairs bacteria elimination.
4. Rheumatoid Arthritis:
o Morning stiffness and pain.
o Adaptive devices (eating utensils) help with independence.
o Chills or fever may indicate infection—see the patient immediately due
to immunosuppressant therapy.
5. Gout:
o Commonly affects the big toe.
o Caused by high uric acid levels.
o Labs to monitor: Uric Acid, ALP, Creatinine.
o Avoid: Alcohol, seafood, shellfish, bacon, turkey, venison.
o Medication: Allopurinol.
6. Osteoarthritis (Asymmetrical):
o Often affects one side or one hand.
o Long-term NSAID use → check for GI bleeding (ask about stool color).
o Therapies: Massage, heat/cold packs (20–30 mins only, never directly on
skin), yoga, steroids.
o Elderly or isolated patient → refer to social services.
Bone Health & Joint Disorders
7. Osteoporosis:
o Caused by loss of bone mass, especially from estrogen loss.
o Contributing factors: Smoking, sedentary lifestyle, eating disorders, aging,
long- term steroid use.
o Diet: Protein, calcium, vitamins C & D (fatty fish, eggs, red meat,
fortified cereal).
Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
, Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
o Medication: Alendronate (take in the morning, empty stomach, with 8 oz
water, stay upright 30–60 mins).
o Post-fall: Assess head-to-toe, don’t move the patient; call PHCP.
8. Joint Replacement:
o Risks: Infection, blood clots, impaired mobility.
o PCA (Patient-Controlled Analgesia): Overuse may cause respiratory depression
— remove control if RR drops.
o DVT prevention: Use TED stockings, ACDs, early ambulation.
9. Knee Replacement & CPM (Continuous Passive Motion):
o Maintain PT settings.
o Check straps (not too tight/loose).
o Monitor for pain.
o Do not remove surgical dressing.
Neurological Disorders
10. Lyme Disease:
• Caused by tick bite.
• S/Sx: Bullseye rash, systemic issues (neurologic, cardiac, cognitive).
• Prevention: Insect repellent with DEET, long sleeves, pants tucked into socks.
• Stiff neck → priority patient (meningitis risk).
11. Kyphosis (often linked to osteoporosis):
• Respiratory/cardiovascular issues, muscle wasting, slow GI function.
12. Amputation:
• Common cause: Trauma.
• Complications: Edema, hemorrhage, hip contracture.
• Phantom pain: Educate before surgery, treat like real pain.
• If limb is amputated accidentally → wrap and put on ice, not in hot water.
• Positive attitude toward recovery is a good sign.
Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
Med serge 2
Autoimmune & Rheumatologic Disorders
1. General Note on Immunosuppressants:
o Treatments suppress the immune system, increasing risk for infection.
o A patient on immunosuppressants with a sore throat is a priority—see them first.
2. Scleroderma:
o Patches appear pale in the center with a purple border.
o Causes hardening of the skin.
o Flares with cold temperatures.
o Often associated with Raynaud’s phenomenon → Keep patient warm.
3. Sjogren’s Syndrome:
o Symptoms: Dry eyes and dry mouth.
o Risk for corneal abrasions (eyes) and gum disease (mouth).
o Dry mouth impairs bacteria elimination.
4. Rheumatoid Arthritis:
o Morning stiffness and pain.
o Adaptive devices (eating utensils) help with independence.
o Chills or fever may indicate infection—see the patient immediately due
to immunosuppressant therapy.
5. Gout:
o Commonly affects the big toe.
o Caused by high uric acid levels.
o Labs to monitor: Uric Acid, ALP, Creatinine.
o Avoid: Alcohol, seafood, shellfish, bacon, turkey, venison.
o Medication: Allopurinol.
6. Osteoarthritis (Asymmetrical):
o Often affects one side or one hand.
o Long-term NSAID use → check for GI bleeding (ask about stool color).
o Therapies: Massage, heat/cold packs (20–30 mins only, never directly on
skin), yoga, steroids.
o Elderly or isolated patient → refer to social services.
Bone Health & Joint Disorders
7. Osteoporosis:
o Caused by loss of bone mass, especially from estrogen loss.
o Contributing factors: Smoking, sedentary lifestyle, eating disorders, aging,
long- term steroid use.
o Diet: Protein, calcium, vitamins C & D (fatty fish, eggs, red meat,
fortified cereal).
Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
, Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
o Medication: Alendronate (take in the morning, empty stomach, with 8 oz
water, stay upright 30–60 mins).
o Post-fall: Assess head-to-toe, don’t move the patient; call PHCP.
8. Joint Replacement:
o Risks: Infection, blood clots, impaired mobility.
o PCA (Patient-Controlled Analgesia): Overuse may cause respiratory depression
— remove control if RR drops.
o DVT prevention: Use TED stockings, ACDs, early ambulation.
9. Knee Replacement & CPM (Continuous Passive Motion):
o Maintain PT settings.
o Check straps (not too tight/loose).
o Monitor for pain.
o Do not remove surgical dressing.
Neurological Disorders
10. Lyme Disease:
• Caused by tick bite.
• S/Sx: Bullseye rash, systemic issues (neurologic, cardiac, cognitive).
• Prevention: Insect repellent with DEET, long sleeves, pants tucked into socks.
• Stiff neck → priority patient (meningitis risk).
11. Kyphosis (often linked to osteoporosis):
• Respiratory/cardiovascular issues, muscle wasting, slow GI function.
12. Amputation:
• Common cause: Trauma.
• Complications: Edema, hemorrhage, hip contracture.
• Phantom pain: Educate before surgery, treat like real pain.
• If limb is amputated accidentally → wrap and put on ice, not in hot water.
• Positive attitude toward recovery is a good sign.
Med Surg II Exam 1 - Autoimmune & Joint Disorders Overview with Complete Solutions
