40. An adolescent with juvenile idiopathic arthritis states to a nurse, "I don't feel any better since I started the NSAIDs a week ago." The nurse's most accurate response would be:
40. An adolescent with juvenile idiopathic arthritis states to a nurse, "I don't feel any better since I started the NSAIDs a week ago." The nurse's most accurate response would be:
. "You need to advance to the slower-acting antirheumatic drugs."
. "You need to give aspirin another try."
. "You need a course of corticosteroids."
. "You need another 2 weeks of NSAIDs."
Test-Taking Tip
Three options suggest something different to consider; the best option implies "wait." Know the medications and their order of usage associated with juvenile idiopathic arthritis.
Content Area: Child Health, Musculoskeletal; Integrated Process: Communication and Documentation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is incorrect because, while 65% of all children with juvenile idiopathic arthritis will require a slower-acting antirheumatic drug (SAARD), it is usually begun after a trial on the nonsteroidal anti-inflammatory drugs (NSAIDs). It may then be used in conjunction with the NSAIDs. Additional time is required to evaluate the effectiveness of the NSAID. Answer 2 is incorrect because, while aspirin (acetylsalicylic acid [ASA]) was once the initial drug of choice in the treatment of juvenile idiopathic arthritis, it is now seldom used in children. It has been replaced with other more effective, less toxic medications. Answer 3 is incorrect because, while corticosteroids are the most potent antiinflammatory agents, they will not cure arthritis, and the significant adverse effects of long-term steroid use are undesirable. Answer 4 is correct because the child must take a nonsteroidal anti-inflammatory drug (NSAID) for at least 3 weeks before the effectiveness of the medication can be evaluated.