Page 2178 - Saunders Comprehensive Review For NCLEX-RN

2. Assessment

a. Pain
b. Stiffness and muscle weakness
c. Pitting edema of the hands and fingers
that progresses to the rest of the body
d. Taut and shiny skin that is free from
wrinkles
e. Skin tissue is tight, hard, and thick;
loses its elasticity; and adheres to
underlying structures.
f. Dysphagia
g. Decreased range of motion
h. Joint contractures
i. Inability to perform activities of daily
living

3. Interventions

a. Encourage activity as tolerated.
b. Maintain a constant room temperature.
c. Provide small frequent meals,
eliminating foods that stimulate gastric
secretions, such as spicy foods,
caffeine, and alcohol.
d. Monitor for esophageal involvement; if
present, advise the client to sit up for 1
to 2 hours after meals. Using
additional pillows and raising the head
of the bed on blocks may help reduce
nocturnal reflux.
e. Provide supportive therapy as the
major organs become affected.
f. Administer corticosteroids as prescribed
for inflammation.
g. Provide emotional support and
encourage the use of resources as
necessary.
D. Polyarteritis nodosa
1. Description
a. Polyarteritis nodosa is a collagen
disease; it is a form of systemic
vasculitis that causes inflammation of
the arteries in visceral organs, brain,
and skin.
b. Treatment is similar to the treatment for
SLE.
c. Polyarteritis nodosa affects middle-aged

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