Week 4 Study Questions, Nursing 162
For this material, using Iggy 5th edition, read chapter 46 pp 977-83 (back pain), and chapter
24 (connective tissue disorders). We will also cover male and female reproductive
problems this week. For that information, read chapter 77, 78 pp 1837-55, and 79 pp 187076.
Back Pain
1. If you were teaching low back pain prevention what tips would you stress with your teaching
group? How can you, as a nurse, take steps to safeguard your own back?
2. Identify the non-surgical techniques used to treat low back pain.
3. The most frequent surgical techniques to relieve back pain are diskectomy and laminectomy.
How does the clinical pathway discussed in class apply to these procedures?
Chapter 21 Clients with Connective Tissue Disease
Our focus here is on arthritis and its effect on function. Other diseases such as gout, Lyme
disease, lupus erythematosus, fibromyalgia, and the other diseases listed in this chapter all have
arthritis-like symptoms. Some, like lupus, have other systemic problems as well. Focus on the
arthritis component but remember you could be asked questions about gout and lupus, often
found on NCLEX exam questions.
1. What are the differences between rheumatoid arthritis (RA) and degenerative joint disease
(DJD) (old name is osteoarthritis). RA has more systemic symptoms. What are they?
2. Why is degenerative joint disease called the "wear and tear" disease? How do older people
cope with it?
3. Rheumatoid arthritis is characterized by chronic pain and inflammation. Outline the
pharmacologic treatments and non-pharmacologic treatments to relieve RA symptoms
4. Surgical treatment of DJD or frozen joints from RA is total joint replacement (TJR).
Postoperative care should be aimed at preventing dislocation of the joint, infection, deep vein
thrombosis, bleeding and neurovascular complications. Outline some critical nursing actions to
prevent these complications.
5. What types of medications would you expect the client to take postoperatively?
6. What abnormal laboratory values would you expect to find in someone with RA?
7. Lupus erythematosus (LE) is a disease with wide ranging symptoms; arthritis is only one of the
problems the client faces. Review how this disease can affect the joints, kidneys, respiratory and
cardiovascular systems. What type of health teaching would you provide to a client with a new
diagnosis of lupus.
8. Gout is another form of arthritis that occurs due to excess uric acid production either from a
genetic error or as a side effect of certain diseases or medications. What are the main
medications used to treat gout and why is diet teaching also important?
9. Lyme disease is another form of connective tissue disease that occurs when a person is
infected by a spirochete bacterium, often from a tick bite. Read over the stages of Lyme disease
in your book. Which type of arthritis does Lyme disease resemble in stage III?
Reproductive disorders.
We are going to focus on a few in each chapter. Focus your reading on the causes/risk factors
for the topics we discuss in class as well as the nursing care surrounding the surgical procedures
that are usually performed
Breast Care
1. What 3 detection techniques are effective in providing early identification and treatment of
breast masses? Which ones do you do?
2. There are multiple risk factors for the development of breast cancer in women, but the most
striking is age. Risk increases as a woman ages. What would you teach women about risk?
What risks can be controlled?
3. We will talk in class about the surgical procedures for breast cancer identification and
treatment. The most critical nursing intervention in the early stages of the disease is helping the
woman to cope with anxiety and fear. What are some effective strategies you can use?
4. Surgical intervention for breast cancer may range from lumpectomy to radical mastectomy. If
lymph nodes are removed then there will be a drain inserted. Outline care of the patient postmastectomy in terms of caring for drainage, comfort, and enhancing mobility and body image.
Female Reproductive Problems
1. In this chapter the outcome of most of these problems is hysterectomy. Some of the benign
reasons this surgery is performed is dysfunctional uterine bleeding, endometriosis, and uterine
leiomyomas. What are these problems and why would the uterus need to be removed?
2. Outline the postoperative care of woman who has had a hysterectomy. Focus on drainage,
wound care, potential complications of abdominal surgery and mobility and the psychosocial
needs of a woman facing this procedure.
3. Malignant neoplasms of the reproductive system are outlined on Table 75-7 in Iggy. Focus on
endometrial cancer, cervical cancer, ovarian cancer and vulvar cancer. Outline the risk factors
and the most frequent treatments used.