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NURS 617 FINAL EXAM STUDY GUIDE | ALL QUESTIONS AND CORRECT ANSWERS | LATEST VERSION | GRADED A+ | VERIFIED ANSWERS | STUDY THIS ONE!$22.99
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NURS 617 FINAL EXAM STUDY GUIDE | ALL
QUESTIONS AND CORRECT ANSWERS |
LATEST VERSION | GRADED A+ | VERIFIED
ANSWERS | STUDY THIS ONE!
What medications used for osteoarthritis are recommended to be limited to
two or three times a year (per affected joint) ------CORRECT ANSWER------
---------Glucocorticoids
Glucocorticoids Used in Rheumatoid Arthritis ------CORRECT ANSWER-----
----------prednisone (Sterapred)
dexamethasone (Decadron dose-pak)
triamcinolone (Kenalog)
Glucocorticoids actions as they relate to rheumatoid arthritis are: ------
CORRECT ANSWER---------------- Suppress inflammation
- Suppress immune responses
- Increase gluconeogenesis
- Promote glycogenolysis
- Increase insulin resistance
- Increase action of proteolytic enzymes and break down protein
- Inhibit protein synthesis
- Increase actions of lipolytic enzymes and break down fat
- Produce sodium and water retention
- Promote the excretion of potassium
Differences when using glucocorticoids for osteoarthritis and rheumatoid
arthritis ------CORRECT ANSWER---------------In osteoarthritis
glucocorticoids are used only for periodic use in acute flare-ups of pain.
They are only administered intra-articularly.
,In rheumatoid arthritis they are available by multiples routes of
administration; the oral route is most often used in the long-term treatment ;
intra-articular injections are used for acute flares
Disadvantages of the Glucocorticoids in Rheumatoid Arthritis ------
CORRECT ANSWER---------------- Hyperglycemia
- Hypertension
- Peptic ulceration
- Pancreatitis
- Psychotomimetic effects (depression, euphoria, psychosis)
- Osteoporosis
- Hypercalcemia
- Weight gain
- May cause Cushing's Syndrome
- May cause easy bruising
- Increased risk of thromboembolism
- Impaired wound healing
- Increased risk of infection
- Must be used with extreme precaution in children
- Stimulates HCl acid secretion in the stomach
- Inhibits gastric mucus production by the stomach
- Affects psychomotor functioning
- Inhibits adrenocorticotropin (ACTH) secretion from the pituitary gland
- Stimulates erythropoiesis; this results in increased red cell count
- Increases coagulability of the blood
- Inhibits cell division
- Inhibits osteoblast activity
, Mainstay of treatment for patients with moderate to severe RA ------
CORRECT ANSWER---------------Methotrexate
Methotrexate is contraindicated in which patients ------CORRECT
ANSWER---------------- Renal insufficiency
- Pregnancy
Methotrexate adverse effects ------CORRECT ANSWER---------------- GI
(Nausea, vomiting, diarrhea, stomatitis)
- Hematologic (decreased white cell count and thrombocytopenia)
- Can cause hepatotoxicity and pulmonary toxicity (pneumonitis)
Can be used early in the course of rheumatoid arthritis and for mild cases
of the disease ------CORRECT ANSWER---------------Hydroxychloroquine
Onset of action for hydroxychloroquine for treatment of RA ------CORRECT
ANSWER---------------Very slow; can range from 6 weeks to 6 months
Hydroxychloroquine adverse effects ------CORRECT ANSWER----------------
May rarely cause nausea, vomiting, anorexia
- Possible ocular toxicity; blurred vision, corneal opacity
- May cause dermatological adverse effects; rash, increased skin
pigmentation, alopecia, photosensitivity
- May rarely cause neurologic toxicity; headache, dizziness, insomnia
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