The nurse suggests that a patient recently diagnosed with ...

[cdr_15]

The nurse suggests that a patient recently diagnosed with rheumatoid arthritis (RA) plan to start each day with
 
  a. a warm bath followed by a short rest.
  b. a short routine of isometric exercises.
  c. active range-of-motion (ROM) exercises.
  d. stretching exercises to relieve joint stiffness.

Question 2

A patient with rheumatoid arthritis (RA) complains to the clinic nurse about having chronically dry eyes. Which action by the nurse is most appropriate?
 
  a. Teach the patient about adverse effects of the RA medications.
  b. Suggest that the patient use over-the-counter (OTC) artificial tears.
  c. Reassure the patient that dry eyes are a common problem with RA.
  d. Ask the health care provider about discontinuing methotrexate (Rheumatrex) .

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Answer to Question 1

ANS: A
Taking a warm shower or bath is recommended to relieve joint stiffness, which is worse in the morning. Isometric exercises would place stress on joints and would not be recommended. Stretching and ROM should be done later in the day, when joint stiffness is decreased.

Answer to Question 2

ANS: B
The patient's dry eyes are consistent with Sjgren's syndrome, a common extraarticular manifestation of RA. Symptomatic therapy such as OTC eye drops is recommended. Dry eyes are not a side effect of methotrexate. Although dry eyes are common in RA, it is more helpful to offer a suggestion to relieve these symptoms than to offer reassurance. The dry eyes are not caused by RA treatment, but by the disease itself.