Chapter 39, assessment and management of patients with rheumatic dis

1. Chapter 39, Assessment and Management of Patients With
Rheumatic Disorders
1. Ellie Long, a 55-year-old patient, presents to the pain clinic
with the diagnosis of fibromyalgia syndrome. The nurse at the
clinic obtains a history and physical assessment of the patient.
(Learning Objective 2)
On what areas should the nurse concentrate when interviewing
the patient during the history process?
On what areas should the nurse concentrate when assessing the
patient?
What diagnostic tests are used with fibromyalgia syndrome?
2. Julie Walker, a 22-year-old patient, is newly diagnosed with
systemic lupus erythematosus (SLE). She presented with
extreme fatigue; muscle and joint aching and swelling; a
butterfly-shaped, flat, red rash across the bridge of the nose;
patchy alopecia; a low-grade fever; and loss of appetite. Further
workup revealed a positive antinuclear antibodies (ANA) titer,
anemia, leucopenia, and mild thrombocytopenia. She has an
abnormal lipid profile, proteinuria, and hypertension. The liver
and renal profiles are within normal range. The physician
ordered over-the-counter ibuprofen as needed for joint
discomfort, but not to exceed 1,200 mg/day;
hydroxychloroquine sulfate (Plaquenil) before meals at the same
time each day; and prednisone in tapering doses over the next
month. The physician also started the patient on lisinopril, an
ACE inhibitor for the hypertension and a statin for the elevated
lipids. The clinic nurse is asked by the physician to provide
patient and family education. (Learning Objective 5)

2. What teaching-plan topics should the nurse provide for the
patient?