J. W., a 46-year-old African American woman, presents to your office, stating the reason for seeking care is stiffness in both shoulders, hands, and wrists in the morning.  She indicates she is healthy otherwise, doesn’t take any medications, and works for a large bank as a systems analyst.  Several weeks ago, she remembers having some minor flulike symptoms.  The stiffness is making it difficult to work extended periods and she has difficulty reaching above her head with her arms to fix her hair.  She indicates she’s lost about 10 pounds in the last 6 months but isn’t dieting.  Driving is becoming more difficult for her, especially when she makes turns and looks back to drive in reverse.  Important lab: ESR 89 mm/hr (0-29mm/hr), ACPA 65 EU/mL (less than 20 EU/mL), SCr 1.0 mg/dL (Arcangelo & Peterson, 2017, p. 625)

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Question Answered step-by-step J. W., a 46-year-old African American woman, presents to your… J. W., a 46-year-old African American woman, presents to your office, stating the reason for seeking care is stiffness in both shoulders, hands, and wrists in the morning.  She indicates she is healthy otherwise, doesn’t take any medications, and works for a large bank as a systems analyst.  Several weeks ago, she remembers having some minor flulike symptoms.  The stiffness is making it difficult to work extended periods and she has difficulty reaching above her head with her arms to fix her hair.  She indicates she’s lost about 10 pounds in the last 6 months but isn’t dieting.  Driving is becoming more difficult for her, especially when she makes turns and looks back to drive in reverse.  Important lab: ESR 89 mm/hr (0-29mm/hr), ACPA 65 EU/mL (less than 20 EU/mL), SCr 1.0 mg/dL (Arcangelo & Peterson, 2017, p. 625) DIAGNOSIS: Rheumatoid Arthritis with moderate disease activity 1.       List specific goals of treatment for J. W.2.       Which drug therapy would you prescribe, and why?3.       What are the parameters for monitoring success of the therapy?4.       Discuss specific patient education based on the prescribed therapy.5.       List any adverse reactions for the selected agent that would cause you to change therapy? Are there any side effects the patient may have that would not lead you to change therapy right away?6.       What would be the choice for second-line therapy?7.       What over-the-counter and/or alternative medications would be appropriate for J. W.?8.       What lifestyle changes should be recommended for J. W.?9.       Describe one or two drug-drug or drug-food interactions for the selected agent. Health Science Science Nursing NURS N521 Share QuestionEmailCopy link Comments (0)