Health Promotion and Maintenance Q 46
Which of the following instructions should be included in the teaching for the client with rheumatoid arthritis?
A. Avoid exercise because it fatigues the joints.
B. Take prescribed anti-inflammatory medications with meals.
C. Alternate hot and cold packs to affected joints.
D. Avoid weight-bearing activity.
Correct Answer: B. Take prescribed anti-inflammatory medications with meals.
Anti-inflammatory drugs should be taken with meals to avoid stomach upset. Disease-modifying, anti-rheumatic drugs (DMARDs) are initiated as soon as the diagnosis of rheumatoid arthritis is made. Traditional or conventional DMARD include methotrexate, leflunomide, sulfasalazine, hydroxychloroquine. Biologic DMARDs include TNF (tumor necrosis factor): Adalimumab, Etanercept, Infliximab, Golilumab, Certolizumab. And non-TNF inhibitors: Tocilizumab (Interleukin-6 inhibitor), Abatacept (inhibits T-cell costimulation), Rituximab (anti-B cell).
Option A: Clients with rheumatoid arthritis should exercise, but not to the point of pain. The patient should enroll in an exercise program to recover joint function. An occupational therapy consult can help the patient manage daily living activities.
Option C: Alternating hot and cold is not necessary, especially because warm, moist soaks are more useful in decreasing pain. Provide a variety of comfort measures (eg, application of heat or cold; massage, position changes, rest; foam mattress, supportive pillow, splints; relaxation techniques, diversional activities).
Option D: Weight-bearing activities such as walking are useful but are not the best answer for the stem. Encourage independence in mobility and assist as needed: Allow ample time for activity; provide rest period after activity; reinforce principles of joint protection and work simplification.