Question

ndvtht effees Celebrex and Ankylosing Spondylitis A.D. Is a 67 year old male with a 10 year history of ankylosing spondylitis. He is seen at his doctor's office for his annual checkup and complains that his Celebrex is not effective. The physician performs a physical examination and finds his overall ROM but his neurologic exam demonstrates a changed in his Deep tendon reflexes from 2+ to 1+ since his last visit. The physician probes to discuss any other changes A.D. has made and A.D. states that he is not taking his Celebrex daily but every other day because the medication has become too expensive on his limited income. Critical Thinking HLA-027 Dosagi? -印 Understanding the pathophysiology of ankylosing spondylitis and how this drug works. How can the nurse explain the importance of taking the medication as prescribed? What key points should the nurse include in teaching? Why do you think A D. condition is worsening? What interventions do you as the nurse see should be implemented to cope with the disease and for A.D. to maintain the appropriate medication regimen? Nursing Care Assessment Allergies: Neurologic Musculoskeletal Skin: Gl: Lab Tests: Nursing Diagnosis mplementation Evaluation Patient Teaching

Answer 1

Q. No 1. Answer :

Ankylosing spondilitis it is one of the Inflammatory Arthritis, that effect the spine and large joints.

The pathophysiology is any new bone forms on the spine which may leads to inflammation of the spine and

* erotion may be taken place.

* it leads to syndesmophytes or bony growth forms the inside of the ligaments of the spine.

* It leads to fusion of the vertebrae on on another

* It leads to rigidity, pain, it may spread from neck to lower back.

* Medicine Celebrex is one of the Non steroidal anti inflammatory drug, which decreases the hormones which are caused for inflammation and pain in this condition.

* Celebrex is a COX 2 inhibitor, this COX 2 is responsible for production of prostaglandines which may causes pain.

* So by reducing COX 2 we can reduces the inflammation and pain, in this type of arthritis.

Importance of taking prescribed medication:

* the medications which are prescribed by physicians that must be taken regularly by client.

* if not takes regularly it may leads to development of drug resistance by the body.

* If the resistence develops there is no use of that medications.

* the body will not respond to that medicine again if once resistance started.

* so regular usage of medicine is important.

Q. No 2. Answer :

Because client age is 67 years , and he is having 10 years history of disease and deep tendon reflexs changed from +2 to +1.

* and also stopped treatment, sudden stopping of treatment my leads to fatal.

* and also long term usage of this celebrex leads to cardiovascular disease like stroke.

So the condition is worsening.

Q. No 3. Answer :

Nursing interventions to cope up with this disease :

* provide psychological support and emotional support.

* Educate regarding do the exercises under the shower because warm and moist water may increases the mobility and decreases stiffness.

* Assist to the clients with Renge of motion exercises at least 3. Times a day.

* Educate regarding drug regimen to the attenders.

* Regarding this side effects and uses.

* use some of alarm techniques to follow correct drug regimen with out forgetting.