A 40-year-old African American patient has scleroderma manifested ...

[Pea0909berry]

A 40-year-old African American patient has scleroderma manifested by CREST (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) syndrome. Which action will the nurse include in the plan of care?
 
  a. Avoid use of capsaicin cream on hands.
  b. Keep environment warm and draft free.
  c. Obtain capillary blood glucose before meals.
  d. Assist to bathroom every 2 hours while awake.

Question 2

The health care provider has prescribed the following collaborative interventions for a patient who is taking azathioprine (Imuran) for systemic lupus erythematosus. Which order will the nurse question?
 
  a. Draw anti-DNA blood titer.
  b. Administer varicella vaccine.
  c. Naproxen (Aleve) 200 mg BID.
  d. Famotidine (Pepcid) 20 mg daily.

[xiazhe]

Answer to Question 1

ANS: B
Keeping the room warm will decrease the incidence of Raynaud's phenomenon, one aspect of the CREST syndrome. Capsaicin cream may be used to improve circulation and decrease pain. There is no need to obtain blood glucose levels or to assist the patient to the bathroom every 2 hours.

Answer to Question 2

ANS: B
Live virus vaccines, such as varicella, are contraindicated in a patient taking immunosuppressive drugs. The other orders are appropriate for the patient.

[Pea0909berry]

Thanks for the timely response, appreciate it

[diana chang]

Excellent