A patient who is being treated for RA reports having continued pain, which the patient describes as moderate and persistent. The NP should prescribe:
a. acetaminophen.
b. a cyclooxygenase-2 (COX-2) inhibitor.
c. an opioid analgesic.
d. an NSAID.
D
NSAIDs are recommended for RA pain because RA is an inflammatory disease. Acetaminophen may be used for mild pain. COX-2 inhibitors appear to cause more stomach ulcers and gastrointestinal (GI) bleeds in patients with RA and so should not be used unless other therapies are ineffective. Opioids should be used for patients with RA when other medications and nonpharmacologic interventions produce inadequate pain relief and the patient's quality of life is affected by pain.
You might also like to view...
What is the type of nursing with a focus on the community as a whole and the health status of individuals as an aggregate?
1) School nursing 2) Community health nursing 3) Community-oriented nursing 4) Public health nursing
As an asthma educator, you are teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. What does a peak flow meter measure?
A) Highest airflow during a forced inspiration B) Highest airflow during a forced expiration C) Highest airflow during a normal inspiration D) Highest airflow during a normal expiration
The client tells the nurse that even though it has been 4 months since her sister's death from a ruptured aneurysm, the client finds herself crying uncontrollably several times a week. The client is afraid she is "losing her mind
" What is the nurse's best response? A. "Most people get on with their lives within a few months. You should see a grief counselor." B. "Whenever you start to cry, distract yourself from thoughts of your sister and try to sing." C. "You should try not to cry. I'm sure your sister is in a better place now." D. "Your feelings are completely normal and may continue for a long time."
The nurse working in a free clinic is caring for a homeless client diagnosed with paranoid schizo-phrenia who has reported that, "I hurt my foot running away from them. It hurts so bad I can hardly walk now."
On assessment the nurse notices bruising on the client's back, arms, and thighs, a red rash on both neck and face, and poor personal hygiene, in addition to edema of the left ankle. The nurse should first realize that this client is at risk for: 1. Physical abuse and assault 2. Drug addiction relating to pain 3. Communicable immune disorders 4. Hospitalization due to mental disorder