The clinic nurse is assessing a child suspected of having juvenile rheumatoid arthritis (JRA). Which of the following assessment items would the nurse expect to find in a child who has been diagnosed with JRA? Select all that apply
1. Hematuria
2. Morning stiffness
3. Painful, stiff, and swollen joints
4. Limited range of motion of the joints
5. Stiffness that develops later in the day
6. History of late afternoon temperature, with temperature spiking up to 105° F
2, 3, 4, 6
Rationale: Clinical manifestations associated with JRA include intermittent joint pain that lasts longer than 6 weeks and painful, stiff, and swollen joints that are warm to the touch, with limited range of motion. The child will complain of morning stiffness and may protect the affected joint or refuse to walk. Systemic symptoms include malaise, fatigue, lethargy, anorexia, weight loss, and growth problems. A history of a late afternoon fever with temperature spiking up to 105° F will also be part of the clinical manifestations.
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A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose
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