Solutions
A patient with ________ may experience hematuria, peripheral
neuropathy, butterfly rash, swan neck deformity, morning
stiffness, ulnar deviation, and they are also at an increased risk
or bone loss and fracture?
Lupus
If a patient with lupus has renal problems such as increased
BUN and creatinine, what might this indicate and what should
be done?
This may indicate lupus nephritis, and we need to change their
therapy to avoid renal damage
ANA is present in 97% of people with what disease?
Lupus (mild proteinuria may also be present)
What might we need to do to assess for proteinuria in lupus
patients?
Obtain a 24 hour urine sample
When assessing patients with symptoms of lupus, what might
you want to ask them about?
Get a good health history because something may have slipped
by in their past doctor visits
What medication should we give to patients with lupus to help
them with inflammation of joints?
,NSAIDs
What medication should someone with lupus not take due to the
risk of it exacerbating their lupus?
Birth control pills (we need to monitor them for possible
pregnanacies as well)
What are the clinical manifestations of ankylosing spondylitis?
-Low back pain
-Stiffness
-Limitation of motion that improves with mild activity (women
have stiffness in the neck rather than the lower back)
-Altered vision
-Aortic insufficiency
-Pulmonary fibrosis
What are clinical manifestations of fibromyalgia?
-Widespread burning
-Sleep disturbances
-Multiple tender points (at least 11 out of 18 points to diagnose)
- (They DON'T have joint inflammation, cardiac palpitations, or
dizziness)
How is fibromyalgia diagnosed?
History of widespread pain that is noted for at least three months
and pain that is experienced in 11 out of 18 tender points on
palpitation
How is systemic exertion intolerance disease characterized?
, It is characterized by fatigue that lasts 6 months or longer and
when they do sleep it is an unrefreshing sleep, they have brain
fog, and their symptoms get worse with standing and exercising
What education would we provide to a patient with systemic
exertion intolerance disease to help treat it?
-Gradually increase ADLs
-Exercise to decrease fatigue
-Give them antihistamines and decongestants to treat their
symptoms
-They need a high fiber diet
-Be sure to tell them that systemic exertion and tolerance disease
does not progress with age
How do we calculate a patient's mean arterial pressure (MAP)?
SBP + DBP + DBP divided by 3
If you walk into a patient's room and they are lying down and
are short of breath, what should you do?
Set them up at a 45-degree angle and assess them for JVD
If you see a new nurse palpating both carotid arteries at the same
time, what should you do?
Stop them because it can cause the patient to pass out or cause a
dysrhythmia
If a patient is experiencing chest pain, what lab should you
draw?
Troponin