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 61 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
:D TYSM

AISCAMPING

  • Member
  • Posts: 347
Reply 3 on: Yesterday
YES! Correct, THANKS for helping me on my review

« previous next »
 

Did you know?

According to the National Institute of Environmental Health Sciences, lung disease is the third leading killer in the United States, responsible for one in seven deaths. It is the leading cause of death among infants under the age of one year.

Did you know?

Symptoms of kidney problems include a loss of appetite, back pain (which may be sudden and intense), chills, abdominal pain, fluid retention, nausea, the urge to urinate, vomiting, and fever.

Did you know?

Chronic necrotizing aspergillosis has a slowly progressive process that, unlike invasive aspergillosis, does not spread to other organ systems or the blood vessels. It most often affects middle-aged and elderly individuals, spreading to surrounding tissue in the lungs. The disease often does not respond to conventionally successful treatments, and requires individualized therapies in order to keep it from becoming life-threatening.

Did you know?

In ancient Rome, many of the richer people in the population had lead-induced gout. The reason for this is unclear. Lead poisoning has also been linked to madness.

Did you know?

Complications of influenza include: bacterial pneumonia, ear and sinus infections, dehydration, and worsening of chronic conditions such as asthma, congestive heart failure, or diabetes.

Tattoos and Body Piercings: This patient developed cellulitis from tattoo ink Tattoos and Body Piercings: This patient developed cellulitis from tattoo ink
Symptoms of a patient in shock. Symptoms of a patient in shock.
Patient wearing an abularm Patient wearing an abularm
The Dederiyeh I infant from Syria preserves nearly the entire skeleton of a 17- to 19- month-old Nea The Dederiyeh I infant from Syria preserves nearly the entire skeleton of a 17- to 19- month-old Nea
Positioning the Patient in the Prone Position Positioning the Patient in the Prone Position
A Mono-Diff test in which the presumptive well contains the patient's serum mixed with ... A Mono-Diff test in which the presumptive well contains the patient's serum mixed with ...
Video: Role of ATP in muscle movement

For a complete list of videos, visit our video library