A patient reports having persistent mild to moderate pain in both knees usually associated with standing. The patient reports knee stiffness for 15 to 20 minutes each morning
The primary care nurse practitioner (NP) learns that the patient has used heating pads and acetaminophen, which no longer relieve the pain. The NP orders an erythrocyte sedimentation rate, which is normal. The NP should consider prescribing: a. aspirin.
b. a cyclooxygenase-2 (COX-2) inhibitor.
c. glucosamine and chondroitin.
d. a topical nonsteroidal antiinflammatory drug (NSAID).
D
Topical NSAIDs, acupuncture, and tramadol are effective for pain relief in knee osteoarthritis. Treatment for osteoarthritis should begin with nonpharmacologic treatment, and acetaminophen should be first-line pharmacologic treatment. NSAIDs should be used when these two measures are no longer effective. COX-2 inhibitors are more expensive and should be used in the presence of gastrointestinal (GI) side effects or for moderate to severe pain. Glucosamine and chondroitin do not relieve most osteoarthritis pain.
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The nurse is administering an otic preparation as part of treatment for a severe fungal ear infection. Why is pramoxine added to the otic medication?
a. It is a corticosteroid that reduces inflammation. b. It is an emulsifying drug that works to soften the cerumen. c. It is a local anesthetic that causes temporary relief of pain. d. It works synergistically to enhance the effect of the antifungal drug.
A 50-year-old patient tells the nurse that he had a smallpox vaccination as a child and is planning to visit a foreign country that has an active smallpox epidemic. His physician suggests that he be revaccinated against the disease
Which of the following does this information suggest to the nurse? 1. The patient did not have a smallpox vaccination as a child. 2. The patient's innate immunity is not sufficient against the smallpox disease. 3. Another vaccination would add to the patient's activite immunity against the disease. 4. Another vaccination will provide a short-lived passive immunity to smallpox.
In implementing the strategic plan for effective utilization of evidence to guide nursing practice at Pacific Hospital, the nursing unit managers take the next step, which is the implementation. Implementation most likely would involve:
a. Revisiting the mission statement and objectives. b. Reevaluating external and internal factors affecting evidence-based practice. c. Preparing a budget to support implementation. d. Developing unit-based objectives related to the plan.
A nurse is caring for a pt with glomerulonephritis. what should the nurse instruct the pt to do to prevent recurrent attacks?
a. take showers instead of tub baths b. continue the same restrictions on fluid intake c. avoid situations that involve physical activity d. seek early treatment for respiratory tract infections