Nurse 125 Exam 4 Questions with Verified Solutions

Nurse 125 Exam 4 Questions with
Verified Solutions

What is the pathophysiology of rheumatoid arthritis? - ANS-Long-term exposure to
unidentified antigen

Normal antibodies become autoantibodies called rheumatoid factors

Cartilage damage from three processes Neutrophils, T cells, other synovial fluid cells
activated, degrade surface layer of articular cartilage

Cytokines cause chondrocytes to attack cartilage

Synovium digests nearby cartilage Formation of pannus tissue

List the general joint manifestation of rheumatoid arthritis - ANS-Typically polyarticular

symmetrical Stiffness In morning lasting more than 1 hour

May be more severe after strenuous activity

Feel spongelike

may be weakness

Clinical Manifestations of Rheumatoid Arthritis in the hands and fingers - ANS-Swan-
neck deformity

Boutonnière deformity

Clinical Manifestations of Rheumatoid Arthritis in the knees - ANS-•Visible swelling
•Joint instability
•Quadriceps atrophy
•Contractures
•Knock-knee

Clinical Manifestations of Rheumatoid Arthritis in the ankles & knees - ANS-•Ambulation
limited by pain, deformities
•Subluxation
•Hallux valgus, lateral deviation of toes
•Cock-up toes

,Clinical Manifestations of Rheumatoid Arthritis in the spine - ANS-•Usually limited to
cervical vertebrae
•Neck pain
•Neurologic complications

Sensory clinical Manifestations of Rheumatoid Arthritis - ANS-Scleritis

Episcleritis

Exocrine gland clinical Manifestations of Rheumatoid Arthritis - ANS-Sjogren syndrome

- dry eyes
- dry mouth

Cardiovascular clinical Manifestations of Rheumatoid Arthritis - ANS-vasculitis
pericarditis

Hematologic clinical Manifestations of Rheumatoid Arthritis - ANS-Felty syndrome
- splenomegaly
- neutropenia
- anemia

Integumentary clinical Manifestations of Rheumatoid Arthritis - ANS-rheumatiod nodules

Respiratory clinical Manifestations of Rheumatoid Arthritis - ANS-pleural disease
interstitial fibrosis
pneumonitis

Musculoskeletal (general) clinical Manifestations of Rheumatoid Arthritis - ANS-
symmetric polyarticular joint swelling

joint redness

warmth

pain

tenderness

morning stiffness

Musculoskeletal (spine) clinical Manifestations of Rheumatoid Arthritis - ANS-cervical
pain
neurologic manifestations

, Musculoskeletal (wrists) clinical Manifestations of Rheumatoid Arthritis - ANS-limited
ROM
deformity
carpal tunnel syndrome

Musculoskeletal (hands) clinical Manifestations of Rheumatoid Arthritis - ANS-ulnar
deviation
swan-neck deformity
boutonniere deformity

Musculoskeletal (knees) clinical Manifestations of Rheumatoid Arthritis - ANS-joint
effusion
instability

Musculoskeletal (ankles) clinical Manifestations of Rheumatoid Arthritis - ANS-Limited
ROM
pain of ambulation

Musculoskeletal (feet) clinical Manifestations Musculoskeletal (general) clinical
Manifestations of Rheumatoid Arthritis - ANS-subluxation

Risk Factors of Rheumatoid Arthritis - ANS-- Family history of RA

- HLA - DR4 genetic marker increases the
risk five times

- Heavy smokers
- Obesity
- Physical, emotional trauma
- Exposure to air pollution, insecticides

-Occupational exposures

Diagnostic tests - ANS--Complete blood count (CBC)

-Rheumatoid factors

-Antibodies to cyclic citrullinated peptide (CCP)

-Erythrocyte sedimentation rate

-C-reactive protein

-X-rays of affected joints

•Rule out other causes of joint pain