Management of Patients With Rheumatic Disorders

Chapter 39, Assessment and Management of Patients With Rheumatic Disorders

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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)

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

Distinguished

(100%)

Proficient

(85%)

Basic

(70%)

Below Expectations

(50%)

Non-Performance

(0%)

Thesis Statement

Raises the strongest objection to the thesis presented in the assignment. The objection is strongly grounded in research and logical reasoning.

Raises a plausible objection to the thesis presented in the assignment. The objection is mostly grounded in research and logical reasoning.

Raises an objection to the thesis presented in the assignment. The objection is somewhat grounded in research and logical reasoning.

Attempts to raise an objection to the thesis presented in the assignment. The objection is minimally grounded in research and logical reasoning.

The objection to the thesis is either nonexistent or lacks the components described in the assignment instructions.

Counter Argument

Provides a strong, thorough rebuttal to the objection. The rebuttal effectively demonstrates that the thesis can withstand the objection and applies the principles of charity and accuracy.

Provides a rebuttal to the objection. The rebuttal mostly demonstrates that the thesis can withstand the objection and mostly applies the principles of charity and accuracy.

Provides a limited rebuttal to the objection. The rebuttal somewhat demonstrates that the thesis can withstand the objection and somewhat applies the principles of charity and accuracy.

Attempts to provide a rebuttal to the objection; however, the rebuttal minimally demonstrates that the thesis can withstand the objection and does not apply the principles of charity and accuracy.

The rebuttal is either nonexistent or lacks the components described in the assignment instructions.

Conclusion

– Provides clear and concise closing remarks that comprehensively summarize the essay. The remarks consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem.

Provides closing remarks that summarize the essay. The remarks mostly consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are somewhat unclear.

Provides closing remarks that minimally summarizes the essay. The remarks minimally consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problems. The closing remarks are unclear and/or vague.

Attempts to provide closing remarks that summarize the essay, however, the remarks do not consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are unclear and vague.

The closing remarks are either nonexistent or lack the components described in the assignment instructions.

Written Communication: Context of and Purpose for Writing

Demonstrates methodical application of organization and presentation of content. The purpose of the writing is evident and easy to understand. Summaries, quotes, and/or paraphrases fit naturally into the sentences and paragraphs. Paper flows smoothly.

Demonstrates sufficient application of organization and presentation of content. The purpose of the writing is, for the most part, clear and easy to understand. There are some problems with the blending of summaries, paraphrases, and quotes. Paper flows somewhat smoothly.

Demonstrates a limited understanding of organization and presentation of content in written work. The purpose of the writing is somewhat evident but may not be integrated throughout the assignment. There are many problems with the blending of summaries, paraphrases, and quotes. Paper does not flow smoothly in all sections.

Organization and presentation of content are extremely limited. The purpose of the writing is unclear. There is little or no blending of summaries, paraphrases, and quotes. Paper does not flow smoothly when read.