Reduce the length of time clients require invasive

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Reduce the length of time clients require invasive devices (medical equipment) - Reservoir: avoid stocking with unnecessary supplies, clean all reusable equipment before using it on another patient, Dispose of all supplies brought to the room when patient is discharged they are contaminated - Mode of transmission: standard precautions, Contact precautions, droplet precautions, airborne pathogens - Portal of entry/ susceptible host: Nutritional support (protein, minerals water); Hygiene(maintenance of intact skin, handwashing); Rest; Exercise; Stress reduction; Immunizations; Immunocompromised pt (protective equipment no fresh flowers no fresh fruit or vegetables; no rare meatl wear gloves gown for personal care) H. Role of antibiotics in infections Inflammation and Connective Tissue Disorders A. Rheumatoid Arthritis 1. Inflammatory autoimmune systemic disease which affects the synovial joints 2. CD4+ helper cells stimulate the release of cytokine release
3. This stimulates neutrophils and other inflammatory cells in the joint to break down cartilage 4. B and T lymphocytes are stimulated and inflammatory response is increased 5. Treatment and treatment goals (including medication goals ex NSAIDS) 6. Assessment - Joint inflammation - Generalized weakness - Fatigue - Anorexia - Weight loss - Persistent low-grade temperature - Upper extremity joints involved, usually interphalangeal joint of the hand showing redness, tenderness, stiff and swollen, Usually bilateral, one hot swollen joint may indicate an infected joint and should be assessed immediately and treated if infected 7. Nursing interventions - Manage pain : NSAIDs with H2 blocking agent - Biological response modifiers : very expensive may not be covered by insurance, high risk for developing impaired immunity and subsequent infection, Must have a TB test prior - DMARDs : Methotrexate ( slow acting, 4-6 wks to control symptoms) cause decrease in WBCs and platelets as a result if bone marrow depression, Elevation of liver enzymes and serum creatinine, Strict birth control - Leflunomide: Slow acting, 100 mg po x3 then 20 mg after, causes hair loss, diarrhea, decrease WBCs and platelets or increase liver enzymes - Steroids: Given for their fast-acting anti-inflammatory and immunosuppressive effects vii. Nonpharmacologic - Adequate and promoting rest - Proper positioning - Ice and heat applications - Hypnosis - Music therapy - Adequate nutrition 8. Diagnostic tests/lab tests - Rheumatic Factor - ANA - Serum complement - ESR - SPEP - Globulin - HLA testing
- Xray, CT - Arthrocentesis: insertion of a large bore needle into the joint to remove synovial fluid to remove pressure, Analyzed for inflammatory cells and immune complexes, Reveals increased WBCs cloudiness and volume - 9. Potential complications-sjogrens, etc Diabetes mellitus, osteoporosis, decreased immunity, glaucoma, hypertension - Steroids B. Raynaud’s phenomenon 1. What is it?

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