Which action will the nurse include in the plan of care for a 40-year-old with newly diagnosed ankylosing spondylitis?
a. Advise the patient to sleep on the back with a flat pillow.
b. Emphasize that application of heat may worsen symptoms.
c. Schedule annual laboratory assessment for the HLA-B27 antigen.
d. Assist patient to choose physical activities that allow the spine to flex.
ANS: A
Because ankylosing spondylitis results in flexion deformity of the spine, postures that extend the spine (such as sleeping on the back and with a flat pillow) are recommended. HLA-B27 antigen levels are used for initial diagnosis, but are not needed annually. To counteract the development of flexion deformities, the patient should choose activities that extend the spine, such as swimming. Heat application is used to decrease localized pain.
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