Nursing Quiz on Gout and Fibromyalgia
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Questions and Answers

What is the main cause of gout?

  • Degenerative arthritis.
  • Inflammation of the joints.
  • Build up of uric acid in joints, bone & tissues. (correct)
  • Kidney stones.

    • Which of the following is NOT a risk factor for gout?

  • Low-purine diet (correct)
  • Obesity
  • Consuming large amounts of alcohol
  • Hypertension

    • What is the most common symptom of acute gout?

  • Tophi formation
  • Joint stiffness
  • Kidney stones
  • Joint pain, redness, and swelling (correct)

    • Which of the following medications are used to treat gout?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the name for gout in the great toe?

    <p>Podagra (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of chronic gout?

    <p>Asymptomatic periods (B)</p> Signup and view all the answers

    What is one nursing intervention for a patient with gout?

    <p>Monitor laboratory values (A)</p> Signup and view all the answers

    What is the main cause of fibromyalgia?

    <p>Abnormal processing of pain signals in the brain (A)</p> Signup and view all the answers

    Which of the following is NOT a common symptom of fibromyalgia?

    <p>Muscle spasms (A)</p> Signup and view all the answers

    Which of the following is a nursing intervention for a patient with fibromyalgia?

    <p>Encourage regular physical activity (D)</p> Signup and view all the answers

    Which of the following is NOT a common trigger for lupus erythematosus?

    <p>Meditation practices (D)</p> Signup and view all the answers

    What is a commonly reported symptom of lupus erythematosus?

    <p>Malar ‘butterfly rash’ (B)</p> Signup and view all the answers

    What is a potential nursing assessment for a patient with scleroderma experiencing renal crisis?

    <p>Check vital signs, focusing on blood pressure (A)</p> Signup and view all the answers

    Which medication is used as an immunosuppressant in the treatment of scleroderma?

    <p>Methotrexate (B)</p> Signup and view all the answers

    Which treatment is specifically indicated for managing the immune response in lupus patients?

    <p>Hydroxychloroquine (C)</p> Signup and view all the answers

    What is a characteristic of systemic lupus erythematosus?

    <p>It can affect any organ within the body (B)</p> Signup and view all the answers

    What complication is NOT typically associated with lupus erythematosus?

    <p>Vitamin D deficiency (D)</p> Signup and view all the answers

    Which nursing intervention is appropriate for maintaining care outcomes in scleroderma patients?

    <p>Maintain pulmonary, cardiac, GI, and renal functions (D)</p> Signup and view all the answers

    Which practice is recommended for patients with lupus erythematosus to prevent exacerbation of symptoms?

    <p>Daily SPF 50 sunscreen application (B)</p> Signup and view all the answers

    Which of the following is NOT typically part of the nursing management for a patient with systemic lupus erythematosus?

    <p>Performing specific diagnostic tests for lupus (A)</p> Signup and view all the answers

    Which nursing intervention is essential for promoting effective coping skills in a patient with fibromyalgia?

    <p>Promoting participation in regular physical activity (D)</p> Signup and view all the answers

    How does a decreased pain level assist in evaluating the effectiveness of treatment for fibromyalgia?

    <p>It reflects successful treatment and self-management. (A)</p> Signup and view all the answers

    What is a common associated symptom of depression in patients with fibromyalgia?

    <p>Chronic pain (B)</p> Signup and view all the answers

    Why is it important to teach fibromyalgia patients about medication management?

    <p>To ensure they take medications only as prescribed (B)</p> Signup and view all the answers

    Which of the following is NOT a nursing intervention associated with managing fibromyalgia?

    <p>Prescribing prolonged periods of inactivity (D)</p> Signup and view all the answers

    What is a common intervention when managing rheumatoid arthritis with adalimumab?

    <p>Teaching the importance of adherence to the treatment plan (A)</p> Signup and view all the answers

    Which demographic is more commonly affected by scleroderma?

    <p>More common in African Americans (D)</p> Signup and view all the answers

    What is a characteristic symptom of limited systemic scleroderma?

    <p>Raynaud's phenomenon preceding the disease (A)</p> Signup and view all the answers

    What is a potential complication of systemic scleroderma?

    <p>Pulmonary artery hypertension (A)</p> Signup and view all the answers

    How does the progression of diffuse scleroderma typically manifest?

    <p>Likely affecting internal organs within two years (C)</p> Signup and view all the answers

    Which sign or symptom is associated with localized scleroderma?

    <p>Hardened patches of skin (D)</p> Signup and view all the answers

    What is an incorrect assumption regarding scleroderma treatment?

    <p>There is a single treatment effective for all cases (B)</p> Signup and view all the answers

    Which of the following is a risk factor for scleroderma?

    <p>Environmental exposure to toxins (B)</p> Signup and view all the answers

    What treatment approach is recommended for patients undergoing immunosuppressive therapy?

    <p>To report any signs of infection promptly (C)</p> Signup and view all the answers

    Which factor is NOT typically seen in scleroderma?

    <p>Increased flexibility of skin (D)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for osteoarthritis?

    <p>Low Vitamin D levels (D)</p> Signup and view all the answers

    What is the most common form of arthritis?

    <p>Osteoarthritis (A)</p> Signup and view all the answers

    Which of the following is NOT a symptom of osteoarthritis?

    <p>Redness and warmth around the affected joint (C)</p> Signup and view all the answers

    Which of the following is a potential complication of osteoarthritis?

    <p>Heart failure (D)</p> Signup and view all the answers

    Which of the following is a non-pharmacological treatment for osteoarthritis?

    <p>Weight loss (A)</p> Signup and view all the answers

    What is the primary function of the synovial membrane in a joint?

    <p>To lubricate the joint (D)</p> Signup and view all the answers

    Which of the following is a characteristic of rheumatoid arthritis but not osteoarthritis?

    <p>Morning stiffness lasting longer than 30 minutes (A)</p> Signup and view all the answers

    What is the role of the immune system in rheumatoid arthritis?

    <p>The immune system attacks the synovial membrane, leading to inflammation. (D)</p> Signup and view all the answers

    Which of the following is NOT a clinical manifestation of rheumatoid arthritis?

    <p>Muscle atrophy (C)</p> Signup and view all the answers

    What is the primary goal of medical management for osteoarthritis?

    <p>To reduce pain and maintain mobility (B)</p> Signup and view all the answers

    Which of the following is a surgical treatment option for severe osteoarthritis?

    <p>Joint replacement surgery (B)</p> Signup and view all the answers

    Which of these is a possible complication of osteoarthritis?

    <p>Heart failure (D)</p> Signup and view all the answers

    What is the primary goal of nursing management for osteoarthritis?

    <p>To provide pain relief and support (D)</p> Signup and view all the answers

    Which of the following is NOT a common joint affected by rheumatoid arthritis?

    <p>Ankles (A)</p> Signup and view all the answers

    What is the difference between rheumatoid arthritis (RA) and osteoarthritis (OA)?

    <p>RA is an autoimmune disease, while OA is a degenerative disease. (A)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for rheumatoid arthritis?

    <p>Exposure to sunlight (B)</p> Signup and view all the answers

    Study Notes

    Coordinating Care for Patients with Connective Tissue Disorders

    • Objectives: The presentation outlines objectives for coordinating care, including exploring clinical manifestations, explaining diagnostic findings, examining medical/nursing approaches, and highlighting teaching aspects for patients with connective tissue disorders.

    • Connective Tissue: It's the most abundant tissue in the body, used for support, protection, and aid in movement. Disease involving this tissue can stem from inflammation or immune system dysfunction.

    Osteoarthritis (OA)

    • Description: The most common form of arthritis, a leading cause of disability in the US, more prevalent in women. Typically affects weight-bearing joints, cervical spine, and hand joints.

    • Pathophysiology: Cartilage loss, unprotected bone, deterioration of joint function, synovial membrane thickening, restriction of joint movement, and muscle atrophy are key features. The image shows normal vs. osteoarthritic knee structure, highlighting differences in cartilage, synovium, and bone.

    • Risk Factors: Female gender, age (>55 years), obesity, occupations, sports, previous injuries, muscle weakness, and genetics are included. Bone and joint disorders are also factors.

    • Symptoms: Progressive pain, decreased range of motion (ROM), morning stiffness (<30 minutes), swelling, deformity, instability, crepitus, and pain with activity, decreasing with rest, are listed.

    • Treatment: Weight loss, heat/cold therapy, aerobic exercise, physical therapy (PT), occupational therapy (OT), Tylenol, NSAIDs, steroid injections, opioids, and surgery (if severe) are mentioned.

    • Joints Affected: The presentation details common joints affected by OA, including cervical spine, hips, knees, wrists, first carpometacarpal joint (thumb), distal interphalangeal joints, proximal interphalangeal joints, and first metatarsophalangeal joint (big toe). Images of affected joints are shown.

    • Medical Management: Diagnosis includes history-taking, laboratory testing, and radiographs. Treatment focuses on decreasing pain and maintaining mobility, with non-pharmacological therapies. Complications such as diabetes and heart failure are referenced.

    • Medications: Acetaminophen, NSAIDs (aspirin, ibuprofen), corticosteroid injections (methylprednisolone), and opioids are listed. Surgical management options include arthroscopic irrigation and/or debridement, synovectomy, and surgical fusion are mentioned.

    • Nursing Management, Assessment & Analysis: Focuses on key areas like unsteady gait, swelling, fatigue, painful ROM, elevated serum creatinine, elevated liver enzymes, constipation, vital signs, weight, pain management, encouragement of PT/OT, and patient education. Monitoring skin integrity is also highlighted.

    • Interventions: The study notes include administering analgesic and anti-inflammatory medications, using cold packs for joints, and using heat pads for muscles.

    • Teaching & Outcomes: Prescribing medications as directed, reporting chest/abdominal pain/abnormal bleeding, participation in regular physical activity, occupational and physical therapy, and orthopedic surgery/home health referrals are crucial aspects of care. Goals include maintaining normal function, pain control, and unrestricted movement as outcomes.

    Rheumatoid Arthritis (RA)

    • Epidemiology: Chronic, systemic, autoimmune disorder but less prevalent than OA, more common in women, and shows symmetrical joint distribution; about 60% of those with RA who don't enter remission are disabled within 10 years. Risk factors include cigarette smoke, bacteria, and viruses.

    • Pathophysiology: Antigen triggers initiating the immune response, leading to synovial tissue damage, increased synovial fluid, impaired movement and pain, and thickened synovial membrane with joint destruction are listed as components. Images of hand joints affected by RA are shown.

    • Clinical Manifestations: Joint pain and swelling, erythema, morning stiffness, fatigue, and irreversible joint damage/disability are key features.

    • Joints Affected: The presentation lists several joints affected by RA: elbows, hips, wrists, temporomandibular joints, cervical spine, shoulders, knees, foot, ankles, metatarsophalangeal joints, hand, metacarpophalangeal joints, and proximal interphalangeal joints.

    • Diagnosis: Six weeks or longer of symptoms, with palpation of synovitis, ultrasound, and inconclusive lab results (antibodies may or may not be present, but rheumatoid factor and elevated CRP/ESR could be indicators). X-rays show erosions/narrowing; MRI if x-rays are unclear.

    • Treatment: PT/OT, ROM exercises, aerobic exercises, healthy nutrition, Tylenol, NSAIDs, Steroids, DMARDs (methotrexate), and surgery are mentioned.

    • Complications: Decreased function, permanent joint deformity, infection, and cancer are noted.

    • Nursing management: assessment & analysis focuses on manifestations (pain, decreased function, side effects of pharmacological therapy), assessments (joint pain and mobility, temperature, labs, and panels), and interventions (analgesics, anti-inflammatories, glucocorticoids, DMARDs, and biologics).

    Scleroderma

    • Epidemiology: 9-19 cases per 1,000,000 people per year, onset typically between 30-50, more prevalent in women, and more common in African Americans. Environmental exposures (infectious agents and occupational toxins) are risk factors.

    • Pathophysiology: Affects skin and internal organs, causing tissue damage, excess insoluble collagen formation, loss of elasticity and movement, and tissue degeneration.

    • Clinical Manifestations: Local (morphea, linear scleroderma, scleroderma en coup de sabre) and systemic (Raynaud's phenomenon, scleroderma renal crisis) are outlined.

    • Diagnosis & Treatment: Presentation focuses on the lack of a single treatment; treatments are tailored to specific organ involvement and clinical manifestations. Steroids (prednisone), immunosuppressants (methotrexate), antihistamines (loratadine), vasodilators (amlodipine), and topical ointments are mentioned. Diagnosis includes signs/symptoms, antibody tests, X-rays, PFTS, echocardiograms, heart catheterizations, and kidney biopsies.

    • Nursing Management: assessment focuses on vital signs, especially high BP and high HR risks for renal and heart issues. This section includes teaching and actions relating to Scleroderma disease process and protecting skin from trauma. Outcomes include maintained skin integrity and functioning of pulmonary, cardiac, GI, and renal systems.

    Systemic Lupus Erythematosus (SLE)

    • Description: A chronic inflammatory disease that can affect any organ. It doesn't follow a pattern, is more common in women, has a genetic predisposition, and presents in flares.

    • Pathophysiology: Chronic inflammatory disease with triggers like pregnancy, sun exposure, illness, major surgery, and environmental exposures (silica dust) or medication allergies.

    • Clinical Manifestations: The most common signs/symptoms are: malar "butterfly rash," fatigue, itchy skin, joint and muscle pain, alopecia, depression/anxiety, stroke, peri/endocarditis, and retinal lesions. Not all patients consistently show these.

    • Complications: Renal failure, premature heart disease, lung disease, hypercoagulation, strokes, and increased risk of infection are highlighted.

    • Treatment: Avoiding sun exposure, proper nutrition, sleep schedule, regular exercise, NSAIDs, hydroxychloroquine, glucocorticoids, and belimumab are mentioned in order to manage symptoms and prevent flareups.

    • Nursing Management: Assessment and interventions for SLE include vital signs monitoring, head-to-toe assessments, lab monitoring (e.g., blood work), medication administration, pain management, patient education, and collaboration with other disciplines.

    Gout

    • Description: A form of inflammatory arthritis characterized by a buildup of uric acid in joints/tissues. It can resolve, or evolve into destructive form of arthritis and commonly affects the big toe (Podagra).

    • Risk Factors: Obesity, hypertension, high purine diet (meat, seafood) and thiazide diuretics are listed. Excessive alcohol consumption is also a concern.

    • Clinical Manifestations: Key aspects include acute onset pain (redness, swelling, tenderness), intercritical periods (asymptomatic between attacks), and chronic form with tophi (uric acid deposits and joint destruction).

    • Diagnosis: Symptoms like red and swollen joints, laboratory tests (serum uric acid levels), microscopic view of crystals present in joints (synovial fluid/tophi), and X-rays reveal joint erosions or nodules are important.

    • Treatment: Weight loss, avoiding alcohol, splinting, Colchicine & Indomethacin (to decrease crystal build-up), glucocorticoids, and allopurinol (for the chronic form) are listed as treatment options. Avoiding aspirin is important, as it can increase uric acid levels.

    • Nursing Management: Key elements are lab value monitoring, skin assessment, pain assessment, medication administration, and ensuring proper patient education are key in effective management of Gout.

    Fibromyalgia

    • Description: A chronic pain disorder affecting soft connective tissue. More common in women, and etiology and pathophysiology are not fully understood.

    • Treatment and Nursing Management: The primary interventions focus on pain management, self-management skills, medications, exercises (PT/OT, strength training, and aerobics), cognitive therapy, regular sleeping patterns, avoiding opioid pain management. Pain management (pain, affect, and mood), vital signs, assessments of patient affect, heat application for pain, encouragement of healthy lifestyle are highlighted areas. Nursing diagnoses include chronic pain, ineffective coping, and depressed mood/sleep patterns. Teaching interventions focus on medication use guidelines, physical activity, effective coping mechanisms, sleep patterns, & collaboration with physicians/therapists.

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