NP1 EXAM 7
1. What are the manifestations of lupus erythematosus?: -involves chronic states w/
minimal or absent symptoms and acute flares w/ elevated symptoms andlab results
-skin rash shaped like a butterfly on face
-joint pain, swelling, and tenderness
-fatigue
-eyes inflammation
-low-grade fever
-wght loss
2. how is lupus diagnosed?: Lab findings along w/ physical history and exam
3. What will labs look like in lupus?: -CBC: pancytopenia
-ANA
-C-reactive protein & ESR
-lupus autoantibody tests
-kidney function tests and urinalysis
4. What is the treatment for lupus?: —NSAIDS
-corticosteriods
-immunosuppressant agents (methotrexate)
-anti malarial drug (hydroxycholoquine)
-anticoagulants
-monoclonal antibodies
5. Hydroxychloroquine: -used for anti-inflammatory properties and to reduce au-toantibodies
-fatigue, joint & skin, help to prevent disease flare-ups & serious organ disease
-may take 1-3 months to work and should be taken long term
-can cause digestive upset
-monitor for visual deficits
6. What is a complication of lupus?: Lupus nephritis
7. What is lupus nephritis?: -caused by chronic kidney disease in clients whoseSLE cannot
be medically managed
-leading cause of death related to SLE
,-monitor for periorbital (puffy eyes) and lower extremity swelling and HTN
-monitor renal status (creatine&BUN)
8. What is the pt education for lupus?: -Avoid prolonged UV & sun exposure, protect with
sunscreen daily, & wear appropriate clothing ( long brimmed hat, longsleeve shirt, and long
pants when outdoors).
-Cleanse skin with mild soap and inspect daily
-Pat skin dry rather thin rubbing
-Apply lotion to dry skin
-Avoid powder and rubbing alcohol to skin
-Use mild soap and avoid harsh hair treatments
-Avoid crowds and individuals who are sick
-Report signs of infection
-Report peripheral and periorbital edema immediately
-Smoking cessation
-Regular exercise (ROM/healthy weight)
-Frequent rest periods and a regular sleep schedule
-Medication regimen compliance
-Frequent evaluation by rheumatologist
9. what is the patho of rheumatoid arthritis?: -chronic autoimmune inflammatorydisorder
-permanent damage to joint
-immune system attacks synovial tissue
-systemic disease w/ multiple extra-articular features
-most commonly found in the hands, wrists, and knees and affects both sides of thesame areas
(symmetrical)
10. what are the manifestations of RA?: -symmetric joint pain
-stiffness
-swelling
-warmth, erythema
-fatigue, lack of function
-pain at rest & w/ movement
-hand deformities: ulnar deviation, swan neck deformity, & RA nodules
, 11. Can rheumatoid arthritis be cured?: no, but it can be treated
12. what are disease modifying anti-rheumatic drugs (DMARDS)?: -med thattreats RA
-slows the progression of RA and suppresses the immune system reaction to RAtherefore
reducing pain, inflammation, and joint damage
-causes immunosuppressive and photosensitivity
-may cause liver problems and pancytopenia
13. what is methotrexate?: -non-biological DMARD
-treats RA
14. what are complications from taking methotrexate?: -Hepatic fibrosis and tox-icity:
+Educate the client to observe unexplained bruising & notify MD
+Monitor liver function tests & kidney function tests
-Bone Marrow suppression:
+Baseline CBC, platelet count, & repeat q 3-6 month.
+Avoid people who have infections
-Ulcerative stomatitis/other GI ulcerations:
+Take medication with food or 8 oz of water
+Inspect mouth, gums, & throat daily for ulcerations, bleeding, or color changes
15. what is pt education for methotrexate?: -Notify MD immediately for signs ofinfection
and stay away from people who have infection
-Notify MD immediately for signs of liver involvement (i.e. unexplained bruising)
-Inspect the mouth daily for ulcerations
-Avoid during pregnancy: Category X
-Using contraception while in use
-Avoid alcohol consumption
-It may take 3 to 6 weeks to achieve the medication's therapeutic effects
16. what is the pt education for rheumatoid arthritis?: -heat (stiffness & pain) andcold (edema)
therapy
-conserve energy, space out activities
-routine checkups (notify MD of concerning S+S)
-alternative therapies (hippie stuff)
1. What are the manifestations of lupus erythematosus?: -involves chronic states w/
minimal or absent symptoms and acute flares w/ elevated symptoms andlab results
-skin rash shaped like a butterfly on face
-joint pain, swelling, and tenderness
-fatigue
-eyes inflammation
-low-grade fever
-wght loss
2. how is lupus diagnosed?: Lab findings along w/ physical history and exam
3. What will labs look like in lupus?: -CBC: pancytopenia
-ANA
-C-reactive protein & ESR
-lupus autoantibody tests
-kidney function tests and urinalysis
4. What is the treatment for lupus?: —NSAIDS
-corticosteriods
-immunosuppressant agents (methotrexate)
-anti malarial drug (hydroxycholoquine)
-anticoagulants
-monoclonal antibodies
5. Hydroxychloroquine: -used for anti-inflammatory properties and to reduce au-toantibodies
-fatigue, joint & skin, help to prevent disease flare-ups & serious organ disease
-may take 1-3 months to work and should be taken long term
-can cause digestive upset
-monitor for visual deficits
6. What is a complication of lupus?: Lupus nephritis
7. What is lupus nephritis?: -caused by chronic kidney disease in clients whoseSLE cannot
be medically managed
-leading cause of death related to SLE
,-monitor for periorbital (puffy eyes) and lower extremity swelling and HTN
-monitor renal status (creatine&BUN)
8. What is the pt education for lupus?: -Avoid prolonged UV & sun exposure, protect with
sunscreen daily, & wear appropriate clothing ( long brimmed hat, longsleeve shirt, and long
pants when outdoors).
-Cleanse skin with mild soap and inspect daily
-Pat skin dry rather thin rubbing
-Apply lotion to dry skin
-Avoid powder and rubbing alcohol to skin
-Use mild soap and avoid harsh hair treatments
-Avoid crowds and individuals who are sick
-Report signs of infection
-Report peripheral and periorbital edema immediately
-Smoking cessation
-Regular exercise (ROM/healthy weight)
-Frequent rest periods and a regular sleep schedule
-Medication regimen compliance
-Frequent evaluation by rheumatologist
9. what is the patho of rheumatoid arthritis?: -chronic autoimmune inflammatorydisorder
-permanent damage to joint
-immune system attacks synovial tissue
-systemic disease w/ multiple extra-articular features
-most commonly found in the hands, wrists, and knees and affects both sides of thesame areas
(symmetrical)
10. what are the manifestations of RA?: -symmetric joint pain
-stiffness
-swelling
-warmth, erythema
-fatigue, lack of function
-pain at rest & w/ movement
-hand deformities: ulnar deviation, swan neck deformity, & RA nodules
, 11. Can rheumatoid arthritis be cured?: no, but it can be treated
12. what are disease modifying anti-rheumatic drugs (DMARDS)?: -med thattreats RA
-slows the progression of RA and suppresses the immune system reaction to RAtherefore
reducing pain, inflammation, and joint damage
-causes immunosuppressive and photosensitivity
-may cause liver problems and pancytopenia
13. what is methotrexate?: -non-biological DMARD
-treats RA
14. what are complications from taking methotrexate?: -Hepatic fibrosis and tox-icity:
+Educate the client to observe unexplained bruising & notify MD
+Monitor liver function tests & kidney function tests
-Bone Marrow suppression:
+Baseline CBC, platelet count, & repeat q 3-6 month.
+Avoid people who have infections
-Ulcerative stomatitis/other GI ulcerations:
+Take medication with food or 8 oz of water
+Inspect mouth, gums, & throat daily for ulcerations, bleeding, or color changes
15. what is pt education for methotrexate?: -Notify MD immediately for signs ofinfection
and stay away from people who have infection
-Notify MD immediately for signs of liver involvement (i.e. unexplained bruising)
-Inspect the mouth daily for ulcerations
-Avoid during pregnancy: Category X
-Using contraception while in use
-Avoid alcohol consumption
-It may take 3 to 6 weeks to achieve the medication's therapeutic effects
16. what is the pt education for rheumatoid arthritis?: -heat (stiffness & pain) andcold (edema)
therapy
-conserve energy, space out activities
-routine checkups (notify MD of concerning S+S)
-alternative therapies (hippie stuff)
