NUR 114 Unit 1 Exam Questions and
Correct Answers
Systemic lupus erythematosus ✅chronic inflammatory disorder of the connective
tissue that causes widespread inflammation and tissue damage.
Only the skin ✅what does discoid lupus erythematous affect?
Patho of lupus ✅autoimmune disorder (r/t genetic or env. Factors) results in production
of antinuclear antibodies(ana), leading to inflammation and damage to most major body
systems (e.g. Skin, lungs, kidneys, heart, etc.). Characterized by periods of
exacerbations and remissions.
Lupus rf ✅female- women of childbearing age
Ages 20-40
Race (african american, asian, hispanic, native american)
Lupus s/s ✅fatigue
Rash on skin exposed to sun
Joint pain
Arthritis
Wt loss
Hives
Discoid lesions
Tachypnea
Cough
Fever
*butterfly rash on face
Raynaud's phenomenon
Anemia
Pericarditis
Lymphadenopathy
Lupus labs/dx ✅*positive ana titer
Esr
Crp
Lupus cell test: positive during exacerbations
Skin biopsy
Decreased serum component (c3, c4)
Decreased rbc, wbc, platelets
Increased bun + cr w/ kidney involvement
0.6-1.2 ✅what is the expected range of cr?
,Indicated the presence of kidney dysfunction ✅what does increased levels of cr mean?
Cr ✅___________ is a more accurate assessment of kidney function than bun.
150,000-400,000/mm3 ✅what is the expected range of platelets?
Hemorrhage, leukemia, splenomegaly ✅what causes lower levels of platelets?
Polycythemia, inflammatory diseases (ra, ibd), infection, cancer, splenectomy ✅what
causes higher levels of platelets?
Bleeding ✅what is low platelets a high risk of?
4.2-5.4 million/ul ✅what is the expected range of rbc for females?
4.7-6.1 million/ul ✅what is the expected range of rbc for men?
Anemia, hemorrhage, kidney disease ✅what causes lower levels of rbc?
Polycythemia, severe dehydration ✅what causes higher levels of rbc?
5,000-10,000/mm3 ✅what is the expected range of wbc?
Autoimmune disease, bone marrow suppression, drug toxicity ✅what causes
leukopenia?
Wbc below 4,000mm3 ✅what is leukopenia?
Infection and inflammation ✅what causes leukocytosis?
Wbc above 10,000mm3 ✅what is leukocytosis?
10-20 mg/dl ✅what is the expected range of bun?
Kidney disease, dehydration, or conditions that decrease blood flow to the kidneys (chf,
mi, shock) ✅what causes a bun to be above 20?
Lupus tx: ✅nsaids
Immunosuppressants (prednisone, methotrexate)
*hydroxychloroquine
Topical steroid creams for rash
Antimalarial drugs
,Nursing care for lupus ✅monitor for complications (renal failure)
Patient teaching for lupus ✅avoid uv/sun exposure and sick people(due to risk of
infection while taking immunosuppressants).
Take frequent rest periods.
Corticosteroid ✅what type of medication is prednisone?
Asthma, autoimmune disorders, inflammatory disorders ✅what are indications of a
corticosteroid?
Decreases inflammation and suppresses the immune response ✅what is the mode of
action for corticosteroids?
Bone loss
Weight gain/fluid retention
Hyperglycemia
Hypokalemia
Infection
Pud
Adrenal gland suppression
Skin fragility
Gi upset ✅what are side effects of corticosteroids?
Monitor for signs of infection + pud (coffee ground emesis, tarry stools)
Periods of stress may require additional doses
Do not stop suddenly (must taper slowly)
Take vit d and calcium supplements
Avoid nsaids ✅corticosteroids
Immunosuppressant ✅what type of drug is hydroxychloroquine?
Ra, lupus, malaria ✅what are the indications of hydroxycholoquine?
Inhibits protein synthesis in susceptible organisms
Including plasmodia that cause malaria
Also reduced inflammation ✅what is the mode of action for hydroxychloroquine?
Gi upset
Vision changes
Seizures
Agranulocytosis ✅what are the side effects of hydroxychloroquine?
Monitor cbc levels during therapy
Take w/ meals to decrease gi upset ✅hydroxychloroquine
, Immunosuppressant ✅what type of drug is methotrexate?
Ra
Psoriasis
Cancers ✅what are the indications of methotrexate?
Inhibits folic acid metabolism, which prevents cell replication. This causes death of
rapidly replicating cell. Also has an immunosuppressive effect. ✅what is the mode of
action for methotrexate?
Infections
Hepatotoxicity
Bone marrow suppression
Gi upset
Stomatitis ✅what are the side effects of methotrexate?
Notify provider right away for signs of infection
Monitor liver function + cbc levels ✅methotrexate
Nsaid(cox 2 inhibitor) ✅what type of drug is celecoxib?
Osteoarthritis
Ra ✅what are indications of celecoxib?
Inhibits cox 2 enzyme, which decreases synthesis of prostaglandins. This results in
decreased pain and inflammation. ✅what is the mode of action fo celecoxib?
Thrombosis (mi, stroke)
Gi bleeding
Rash ✅what are the side effects of celecoxib?
Do not administer with allergy to aspirin , nsaids, or sulfonamides ✅celecoxib
Ibuprofen
Naproxen
Ketorolac
Indomethacin ✅what are the normal nsaids?
Mild to moderate pain, fever, inflammation
Indomethacin is used to close pda in premature babies ✅what are the indications of
nsaids?
Inhibits prostaglandin synthesis ✅what is the mode of action for nsaids?
