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MS2 NURS 2207 EXAM 3 - Musculoskeletal And Neuro: Questions And Answers
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MS2 NURS 2207 EXAM 3 - Musculoskeletal And Neuro: Questions And Answers
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MS2 NURS 2207 EXAM 3 - Musculoskeletal And Neuro:Questions And Answers
Rheumatoid Arthritis: Right Ans - a chronic autoimmune disorder in which
the joints and some organs of other body systems are attacked. Patients
experience period of remission and exacerbation. Cause is unknown
(potentially genetics).
What gender is affected more with Rheumatoid Arthritis: Right Ans -
women 3x more often than men and can occur at any age!
What is the pathology behind Rheumatoid Arthritis: Right Ans - RA antigen
or factor triggers the start of a response in the body. This binds with IgG
leading to damage to cartilage and thickens synovial fluid between the joints.
Cascade of inflammation takes place.
(Can lead to abnormal lab levels for RA Factor!)
Difference between RA and OA: Right Ans - RA: SYMETRICAL
OA: ASYMETRICAL
How to remember OA: Right Ans - When you see the "A" in OA think
"ASYMMETRICAL!"
Manifestations of Rheumatoid Arthritis: Right Ans - 1. OFTEN insidious and
gradual
2. Symmetrical joint pain
3. Morning stiffness lasting longer than 30 minutes and with inactivity
4. Stress might can trigger and exacerbation
5. Joints are painful, stiff, inflamed, have poor ROM
6. Palpation reveals spongy and boggy tissue
7. Fatigue
8. Anorexia
9. Weight Loss or Gain
10. Tenosynovitis
11. Deformity
12. Subluxation
13. Disability
14. Nodules
,15. Certain Syndromes
Why is weight loss or gain common with Rheumatoid Arthritis: Right Ans -
Weigh Gain: due to them eating finger foods and foods that are bad for their
health.
Weight Loss: due to not being able cook for self or even go shopping for food
due to this condition
What are some common areas for Rheumatoid Arthritis to occur: Right Ans
- 1. MCP (Metacarpophalangeal joint)
2. PIP (Proximal interphalangeal joint)
3. Wrist
4. Elbow
5. Hips
6. Knees
7. Ankles
8. Jaw
9. Cervical Spine
(MORE COMMON IN DISTAL JOINTS!)
Spindling: Right Ans - fingers or toes begin to appear in different ways.
Most people won't seek care until this is seen!
(DEFORMITIES: LATE SIGN!)
Nodules for RA: Right Ans - often firm, nontender and within the
subcutaneous layer. Kind of look like granulomas. Common on bony areas.
SCLERA: they can lead to cataracts and vision loss!
OTHER LOCATIONS:
can lead to pericarditis, pleural effusion and other complcaitions
Do we treat skin Nodules for RA: Right Ans - NO TX NEEDED!
Sjorgren's Syndrome (RA): Right Ans - is an autoimmune disorder where
the body's immune system attacks moisture-producing glands, leading to dry
,eyes and mouth. Decrease production in the lacrimal and salivary glands. Can
be with RA plus Lupus or just RA!
Common S/S:
- Dry mouth
- Dry eyes (no tears)
- Photosensitivity
How to remember Sjorgren's Syndrome (RA): Right Ans - "Dry People
Blink Less!"
- Dry: Dry mouth
- People: Photosensitivity
- Blink: Dry eyes (can't blink if they are dry!)
- Less: not properly lubricated
Felty Syndrome (RA): Right Ans - is a rare complication of rheumatoid
arthritis characterized by an enlarged spleen, low white blood cell count, and
increased risk of infections.
Common S/S:
- Enlarged Spleen
- Low white blood cells
- HIGH RISK for infection
How to remember Felty Syndrome (RA): Right Ans - "SANTA"
- S: spleen enlarged
- A: autoimmune
- N: neutropenia
- T: threat of infection
- A: arthritis (RA!)
What is another disease process that is common with Rheumatoid Arthritis:
Right Ans - because inflammation from RA can damage blood vessels, leading
to poor circulation and triggering Raynaud's episodes in response to cold or
stress.
(RED, WHITE & BLUE!)
, Diagnosis for Rheumatoid Arthritis: Right Ans - Point System is used. Need
to score 6 or higher. The categories include joint involvement, RH factor lab
level, how long does an acute attack last, placed in remission and how long
until the next admission
What are some common labs for Rheumatoid Arthritis: Right Ans - 1. ESR
(SED Rate)
2. ANA (antibodies)
3. WBC
ESR (SED Rate): Right Ans - Females: 0 to 22
Males: 0 to 29
What are some common procedures for Rheumatoid Arthritis: Right Ans -
1. Arthrocentesis
2. X-rays
Arthrocentsis: Right Ans - - Early RA: fluid should be slightly cloudy
- Progression of RA: turns milky with a yellow color. Can even have fragments
of fibrin in it.
Treatment for Rheumatoid Arthritis: Right Ans - 1. Want to get patients in
remission if in the active phases
2. Promote the most ROM possible. Bring them to a good level of functioning
and care providing for self.
3. Prevent joint deformities
4. Educations
Common medications for Rheumatoid Arthritis: Right Ans - 1. DMARDs
(Nonbiologic or Biologic)
2. NSAIDs
3. Salicylates
4. Corticosteroids
5. Antidepressants
6. Immunosuppresive Therapy
7. Gold Salts-Compounds
Non Biological DMARDs examples: Right Ans - 1. Methotrexate
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