After the nurse assesses a 78-year-old who uses naproxen (Aleve) ...

[Brittanyd9008]

After the nurse assesses a 78-year-old who uses naproxen (Aleve) daily for hand and knee osteoarthritis management, which information is most important to report to the health care provider?
 
  a. Knee crepitation is noted with normal knee range of motion.
  b. Patient reports embarrassment about having Heberden's nodes.
  c. Patient's knee pain while golfing has increased over the last year.
  d. Laboratory results indicate blood urea nitrogen (BUN) is elevated.

Question 2

A 28-year-old with psoriatic arthritis and back pain is receiving etanercept (Enbrel). Which finding is most important for the nurse to report to the health care provider?
 
  a. Crackles are heard in both lung bases.
  b. Red, scaly patches are noted on the arms.
  c. Hemoglobin level is 11.1g/dL and hematocrit is 35.
  d. Patient reports continued back pain after a week of etanercept therapy.

[eliasc0401]

Answer to Question 1

ANS: D
Older patients are at increased risk for renal toxicity caused by nonsteroidal antiinflammatory drugs (NSAIDs) such as naproxen. The other information will also be reported to the health care provider but is consistent with the patient's diagnosis of osteoarthritis and will not require an immediate change in the patient's treatment plan.

Answer to Question 2

ANS: A
Because heart failure is a possible adverse effect of etanercept, the medication may need to be discontinued. The other information will also be reported to the health care provider but does not indicate a need for a change in treatment. Red, scaly patches of skin and mild anemia are commonly seen with psoriatic arthritis. Treatment with biologic therapies requires time to improve symptoms.

[Brittanyd9008]

Excellent

[FergA]

TYSM