This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A patient who has been diagnosed with rheumatoid arthritis for 1 month and has generalized symptoms ... (Read 27 times)

colton

  • Hero Member
  • *****
  • Posts: 627
on: Jul 23, 2018
A patient who has been diagnosed with rheumatoid arthritis for 1 month and has generalized symptoms is taking high-dose NSAIDs and an oral glucocorticoid. The provider has ordered methotrexate (Rheumatrex).
 
  The patient asks the nurse why methotrexate is necessary since pain and swelling have been well controlled with the other medications. The nurse will tell the patient that:
  a. a methotrexate regimen can reduce overall costs and side effects of treatment.
  b. starting methotrexate early can help delay joint degeneration.
  c. starting methotrexate now will help increase life expectancy.
  d. with methotrexate, doses of NSAIDs can be reduced to less toxic levels.

Question 2

A patient who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes that the patient's cheeks appear full and that a prominent hump of fat is present on the upper back.
 
  The nurse will ask the provider to order which test(s)?
  a. Liver function tests
  b. Serum electrolytes
  c. Tuberculin skin test
  d. Vitamin D levels


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

tranoy

  • Sr. Member
  • ****
  • Posts: 344
Reply #1 on: Jul 23, 2018
Answer to Question 1

ANS: B
Current guidelines for treatment of RA recommend starting a DMARD earlywithin 3 months of diagnosis for most patientsin order to delay joint degeneration. Methotrexate may take up to 3 to 6 weeks to be at therapeutic levels, so NSAIDs and glucocorticoids should be continued until this occurs. Methotrexate is expensive and has more toxic side effects. Patients taking methotrexate have been shown in some data to have decreased life expectancy. Patients may eventually be able to stop taking NSAIDs altogether.

Answer to Question 2

ANS: B
This patient shows signs of iatrogenic Cushing's syndrome, which may include serum electrolyte disturbances; therefore, the electrolyte levels should be monitored. Liver function tests, tuberculin skin testing, and vitamin D levels are not indicated.


colton

  • Member
  • Posts: 627
Reply 2 on: Jul 23, 2018
Excellent

T4T

  • Member
  • Posts: 348
Reply 3 on: Yesterday
Wow, this really help

« previous next »
 

Did you know?

Many people have small pouches in their colons that bulge outward through weak spots. Each pouch is called a diverticulum. About 10% of Americans older than age 40 years have diverticulosis, which, when the pouches become infected or inflamed, is called diverticulitis. The main cause of diverticular disease is a low-fiber diet.

Did you know?

Bisphosphonates were first developed in the nineteenth century. They were first investigated for use in disorders of bone metabolism in the 1960s. They are now used clinically for the treatment of osteoporosis, Paget's disease, bone metastasis, multiple myeloma, and other conditions that feature bone fragility.

Did you know?

The modern decimal position system was the invention of the Hindus (around 800 AD), involving the placing of numerals to indicate their value (units, tens, hundreds, and so on).

Did you know?

It is believed that the Incas used anesthesia. Evidence supports the theory that shamans chewed cocoa leaves and drilled holes into the heads of patients (letting evil spirits escape), spitting into the wounds they made. The mixture of cocaine, saliva, and resin numbed the site enough to allow hours of drilling.

Did you know?

Nitroglycerin is used to alleviate various heart-related conditions, and it is also the chief component of dynamite (but mixed in a solid clay base to stabilize it).

Hypothyroidism. Hyposecretion of the thyroid gland produces the symptoms that are illustrated. Hypothyroidism. Hyposecretion of the thyroid gland produces the symptoms that are illustrated.
Treating the pregnant patient Treating the pregnant patient
Fractures are diagnosed based on an X-ray of the broken bone. Shown here: a comminuted fracture of ... Fractures are diagnosed based on an X-ray of the broken bone. Shown here: a comminuted fracture of ...
The physician will begin visual inspection of the patient immediately upon entering the examination ... The physician will begin visual inspection of the patient immediately upon entering the examination ...
Aquamatic pad and heating unit provide dry heat treatment to a patient’s arm. Aquamatic pad and heating unit provide dry heat treatment to a patient’s arm.
Edentulous patient with pieces of bone that became necrotic and continued to slough off after tooth ... Edentulous patient with pieces of bone that became necrotic and continued to slough off after tooth ...
Video: Leukemia

For a complete list of videos, visit our video library