Question

Ms. Alvarez., a Hispanic 68 year old, has just been diagnosed with Rheumatoid Arthritis and just came back from the hospital today. She speaks moderate English. She has been living in the Assisted Living facility for the past 2 yrs. Medical history of Migraine, Diabetes type 2, Hyperlipidemia, and obesity.
Allergy: Penicillin (PCN)
Medications: Atorvastatin 20 mg PO daily
Ibuprofen 200mg PO PRN every 6 hours
Metformin 1000mg PO BID
New medication prescribed today: Leflunomide 100 mg PO daily for 3 day initially, then 10mg po daily.

Diet--Low cholesterol, Carb controlled diet. Partial lower denture
Activity as tolerated; uses cane as needed, not all the time.
Orders: Liver Function Test now and in 3 months, Hepatitis B, Hepatitis C panels now.

Design a care plan for this patient with at least 1 nursing diagnosis.

Answer 1

Answer: Rheumatoid arthritis causes pain, stiffness, swelling in the joints. The nursing intervention includes:

• Nursing diagnosis: Acute pain
• Risk factors : It includes injury, uncomfortable while walking, accumulation of fluid.
• Desired outcomes: Patient may feel comfort as reduced pain level. Reduced weight.

Nursing intervention:

Measure the pain of the patient on the scalescale of 0-10.

• Rationale: It will provide the level of discomfort and pain. Hence the pain management can be done accordingly.

Encourage patient for the change in the resting position.

• Rationale: It will prevent from bed sore.

Recommend patient to have lukewarm shower.

• Rationale: This will reduce the pain.

Ask patient to do mild exercise such as little walk.

• Rationale: This will helps in reducing the weight. Hence also manage the diabetes and reduces obesity.

Provide proper medications to the patient. Aspirin can be taken to reduce the pain. Patient should be educated to take medicines on time.

• Rationale: It will reduce pain. It will also manage the diabetes and hence patient can feel comfortable.