When educating the patient with ankylosing spondylitis, the nurse ...

[altibaby]

When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply.
 
  A)
  Encourage sleeping supine on an extra firm mattress if possible.
  B)
  Prop self up in bed with extra pillows if having respiratory congestion.
  C)
  Try using the heating pad prior to exercise to help stretching and improve movement.
  D)
  Wear a knee immobilizer while biking to facilitate ability to exercise for longer periods.
  E)
  Modify diet to include more protein from red meats and green vegetables for vitamin K.

Question 2

Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected.
 
  There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after 3 weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe
  A)
  complete bed rest with immobilization of the knee.
  B)
  high doses of nonsteroidal anti-inflammatory drugs.
  C)
  antimicrobial treatment depending on the microbe.
  D)
  wound irrigations with hydrogen peroxide twice daily.

[pallen55]

Answer to Question 1

Ans:
A, C

Feedback:

Treatment of ankylosing spondylitis is directed at controlling pain and maintaining mobility by suppressing inflammation. Proper posture and position are important. This includes sleeping in a supine position on a firm mattress using one small pillow. Therapeutic exercises are important. Heat applications or a shower or bath may be beneficial before exercise to improve ease of movement. Swimming is an excellent exercise. Immobilizing joints is not recommended. Maintaining ideal weight reduces the stress on weight-bearing joints. However, dietary changes are usually very individualized.

Answer to Question 2

Ans:
C

Feedback:

Treatment includes the use of antibiotics and selective use of surgical interventions. Antimicrobial agents are usually used prophylactically in persons undergoing bone surgery. For persons with osteomyelitis, early antimicrobial treatment, before there is extensive destruction of bone, produces the best results. Bed rest is not encouraged. The patient may be given NSAIDs for pain, but usually he or she will require a more potent pain killer. Wound irrigations are usually performed in OR rather than at bedside for infected prosthetic joints.

[altibaby]

TYSM

[bdobbins]

Excellent