Author Question: A 36-year-old patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse ... (Read 73 times)

nevelica · **on:** Jun 25, 2018

A 36-year-old patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include when teaching the patient about this medication?

Select all that apply.

1. Avoid alcohol.
2. Avoid exposure to sunlight.
3. Use effective contraception.
4. Expect the skin to turn orange.
5. Have routine eye examinations.

Question 2

While completing a health history the nurse suspects that the patient is experiencing manifestations of scleroderma. What did the nurse assess to make this clinical decision?

Select all that apply.

1. dysphagia
2. hypotension
3. telangectasias
4. exertional dyspnea
5. pursed-lip appearance

cloudre37 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1, 2, 3
The nurse should instruct the patient to avoid alcohol and exposure to sunlight or ultraviolet light and to practice effective contraception while taking methotrexate. Yellow-orange skin is associated with sulfasalazine (Azulfidine). Routine ophthalmologic examinations are needed for hydroxychloroquine (Plaquenil) because of the risk of developing retinopathy.

Answer to Question 2

Correct Answer: 1, 3, 4, 5
The patient with visceral organ involvement may have varied symptoms. Dysphagia is common because the motility of the esophagus is affected. Pulmonary involvement can lead to exertional dyspnea due to impaired gas exchange and right-sided heart failure due to pulmonary hypertension. Skin manifestations include telangiectasias. Facial skin tightening leads to a pursed-lip appearance.