Skip to document
Welcome to StudocuSign in to access the best study resources
Guest user
0followers
HomeMy LibraryAsk AI
  • You don't have any recent items yet.
My Library
  • You don't have any courses yet.
  • You don't have any books yet.
  • You don't have any Studylists yet.
Premium
This is a Premium Document. Some documents on Studocu are Premium. Upgrade to Premium to unlock it.

Med Surg Chapter 38 - med surg notes

med surg notes
Course

Medical Surgical Clinical (NSG 345C)

5 Documents
Students shared 5 documents in this course
Academic year: 2018/2019
Uploaded by:
Anonymous Student
This document has been uploaded by a student, just like you, who decided to remain anonymous.
University of Phoenix

Comments

Please sign in or register to post comments.

Students also viewed

Related documents

Related Studylists

MSIIMedsurg#2

Preview text

Nursing Chapter Assessment and Management of Patients with Rheumatic Disorders Rheumatic Diseases o Affects males and females of all ages and ethnic groups Three distinct characteristics: inflammation, autoimmunity, and degradation o a complex physiologic process mediated the immune system that occurs in response to harmful stimuli like damaged cells or antigens, which may include pathogens o where the body mistakenly recognizes its own tissue as a foreign antigen o known to be metabolically active and therefore more accurately called degradation Manifestations: o Joint swelling o Limited movement o Stiffness o Weakness o Fatigue Diagnostic Findings: o General health hx o Laboratory studies o Other diagnostics: CT scans MRI scans Arthrography Treatment: o Pharmacologic therapy Salicylates NSAIDs Both antirheumatic drugs (DMARDs) o Nonpharmacologic Pain Management Heat application Devices such as braces, splints, assistive devices (canes, crutches, walkers) Cervical collars o Exercise and Activity o Sleep Gerontologic Considerations: o Comorbid conditions pose a challenge in diagnosing rheumatologic disease because they have the potential to presenting symptoms Diffuse Connective Tissue Disease Refers to a group of systemic disorders that are chronic in nature and are characterized diffuse inflammation and degeneration in the connective tissues Rheumatoid Arthritis An autoimmune disease of unknown origin that affects of the population worldwide, with females having a 2 times greater incidence than males Manifestations: o Criteria for classifying based on a point system where a total score of 6 or greater is required for the diagnosis of RA Joint movement Serology Abnormal results of acute phase reactants Duration of symptoms greater than 6 weeks o Symptoms are usually bilateral and symmetric o Symmetric joint pain and morning joint stiffness lasting more than 1 hr o Swelling o Warmth o Erythema o Lack of function o Fever o Weight loss o Fatigue o Anemia o Lymph node enlargement o phenomenon Findings: o Antibodies to cyclic citrullinated peptide o ESR and CRP o CBC o TB skin test o Hepatitis B and Hepatitis C o o Ultrasound o MRI o Arthrocentesis o Recommended tests on synovial fluid: WBC with differential, cultures, gram stain, and crystals Treatment: o Early RA: DMARD NSAIDs o Moderate, Erosive RA o Nephritis o Psychosis o Cognitive impairment o Seizures o Cranial neuropathies o Transverse myelitis o Strokes Findings: o Complete history o Physical examination o Blood tests Treatment: o Monoclonal antibodies o Corticosteroids o Antimalarial agents o NSAIDs o Immunosuppressive agents Complications: o Organ damage Syndrome A systemic autoimmune disease that progressively affects the lacrimal and salivary glands of the body 1. More than are women, onset tends to begin between 35 and 50 yrs of age Clinical Manifestations: o o o o o o o o o o o o o o o o o Kerotoconjunctivitis sicca (dry eyes) Xerostomia (dry mouth) Redness in eyes Lack of tearing Mouth will have dry and sticky mucous membranes Difficulty swallowing Palpable purpura Optic neuritis Trigeminal neuralgia Sensory neuropathy Burning pain in extremities Numbess Vertigo Arthralgia myalgia phenomenon Cough Dyspnea o Abdominal pain Findings: o Six distinct indices: Ocular symptoms Positive ocular tests Oral symptoms Histopathology of the glands Salivary gland involvement o Autoantibodies to ribonucleoprotein particles o ANA, circulating DNA (cDNA), and anticentromere antibody (ACA) o Skin biopsy o Nerve conductions studies o MRI o Electroencephalograms o Cerebral spinal fluid testing Treatment: o No cure o Eye drops o Ocular ointments o Systemic cholinergic agents o Biotene oral rinse o Eat small frequent meals o Avoid eating: spicy, salty, irritating foods, smoking, excessive alcohol, and drugs with anticholinergic effects Scleroderma A compilation of autoimmune diseases affecting the connective tissue of the skin, blood vessel walls, and internal organs Two general types: 1. affecting only the cutaneous system 2. Systemic (systemic affecting multiple organ systems Clinical Manifestations: o Swelling in hands o phenomenon o Skin becomes hard, rigid, dry o Extremities stiffen and lose mobility o Face appears masklike, immobile, expressionless, and mouth becomes rigid o Pulmonary hypertension o Digestive disturbances o CREST syndrome: calcinosis (calcium deposits in the tissues), phenomenon, esophageal hardening and dysfunction, sclerodactyly (scleroderma of the digits) and telangiectasia (capillary dilation that forms of the digits) Complications: o Progressive kidney failure PRM: o Clinical Manifestations: Severe proximal muscle discomfort Mild joint swelling Severe aching in the neck, shoulder, and pelvic muscles Stiffness fever Weight loss Malaise Anorexia Depression GCA: o Clinical Manifestations: Headaches Changes in vision Jaw claudication o Complications: Permanent loss of vision Findings: o MRI o ESR screening test o CRP and platelet count o Biopsy of the temporal artery Treatment: o PMR without GCA: Moderate doses of corticosteroids NSAIDs o GCA: Rapid initiation of corticosteroids Aspirin Osteoarthritis (Degenerative Joint Disease) A noninflammatory degenerative disorder of the joints Clinical Manifestations: o Pain o Stiffness o Functional impairment o Crepitus o Joint effusion Findings: o Blood tests o Examination of joint fluid o Treatment: o o o o o o o o o o o Exercise Wedged insoles Knee braces Orthotic devices (splints, braces) Walking aids (canes) Complementary, alternative, integrative health therapies supplements Analgesic therapy Opioids corticosteroids Arthroplasty Spondyloarthropathies A category of systemic inflammation disorders of the skeleton Ankylosing Spondylitis (AS) A chronic and inflammatory disease of the spine More prevalent and severe in males Clinical Manifestations: o Kyphosis Complications: o o o o o Osteoporosis Atrioventricular conduction defects Aortic insufficiency Pulmonary fibrosis Respiratory compromise Reactive Arthritis Syndrome) Arthritis that occurs after an infection, primarily Mostly affects young males Clinical Manifestations: o o o o o o Urethritis Arthritis Conjunctivitis Dermatitis Ulcerations of the mouth and penis Low back pain Psoriatic Arthritis Psoriatic arthritis is an inflammatory arthritis associated with the skin disease psoriasis o of people with psoriasis will eventually develop psoriatic arthritis Fibromyalgia A chronic pain syndrome Findings: o Preliminary diagnostic criteria and symptom severity indices Clinical Manifestations: o Chronic fatigue o Generalized muscle aching o Stiffness o Sleep disturbances o Functional impairment Treatment: o NSAIDs o Tricyclic Antidepressants (TCAs) o Muscle relaxants o Cognitive behavioral therapy o Serotonin norepinephrine reuptake inhibitors (SNRIs) o Selective serotonin reuptake inhibitors (SSRIs) o Anticonvulsants o Complimentary, alternative and integrative therapies

Was this document helpful?
Premium
This is a Premium Document. Some documents on Studocu are Premium. Upgrade to Premium to unlock it.

Med Surg Chapter 38 - med surg notes

Course: Medical Surgical Clinical (NSG 345C)

5 Documents
Students shared 5 documents in this course

University: University of Phoenix

Was this document helpful?

This is a preview

Do you want full access? Go Premium and unlock all 10 pages

  • Access to all documents

  • Get Unlimited Downloads

  • Improve your grades

Upload

Share your documents to unlock

Already Premium?
Medical-Surgical Nursing
Chapter 38- Assessment and Management of Patients with Rheumatic Disorders
Rheumatic Diseases
oAffects males and females of all ages and ethnic groups
Three distinct characteristics: inflammation, autoimmunity, and degradation
oInflammation- a complex physiologic process mediated by the immune system
that occurs in response to harmful stimuli like damaged cells or antigens, which
may include pathogens
oAutoimmunity- where the body mistakenly recognizes its own tissue as a foreign
antigen
oDegeneration- known to be metabolically active and therefore more accurately
called degradation
Manifestations:
oJoint swelling
oLimited movement
oStiffness
oWeakness
oFatigue
Assessment/ Diagnostic Findings:
oGeneral health hx
oLaboratory studies
oOther diagnostics:
X-ray
CT scans
MRI scans
Arthrography
Treatment:
oPharmacologic therapy
Salicylates
NSAIDs
Both biologic/nonbiologic disease-modifying antirheumatic drugs
(DMARDs)
oNonpharmacologic Pain Management
Heat application
Devices such as braces, splints, assistive devices (canes, crutches,
walkers)
Cervical collars
oExercise and Activity
oSleep
Gerontologic Considerations:
oComorbid conditions pose a challenge in diagnosing rheumatologic disease
because they have the potential to mask/alter presenting symptoms

Why is this page out of focus?

This is a Premium document. Become Premium to read the whole document.

Why is this page out of focus?

This is a Premium document. Become Premium to read the whole document.

Why is this page out of focus?

This is a Premium document. Become Premium to read the whole document.

Students also viewed

Related documents