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. and 6 nursing interventions

Answer 1

Rhumatoid arthritis is an autoimmune disorder characterized by the inflamation and swelling of the more than two joints of the body.

Here in the above case Mr. Alvarez is suffering from rhumatoid arthritis. So the nursing care plan for the client will be =

Assessment =

- monitor the vital signs of the client.

- take proper history of the client in detail.

- head to toe physical examination of the client with special emphasis on masculo skeletal system.

- Identify number of joints involved inflamation.

- nutritional assessment of the client.

Diagnosis =

Impair movement related to inflammation and swelling of the joints, pain in jointa, secondary to rhumatoid arthritis as evidenced by physical examination and patient's verbalisation of the client.

Goal =

Reduce the impair movement and fulfill the basic needs of the client.

Interventions =

i. Assess the level of deformity of the joints and impaired movement.

ii. Proper range of motion has to be done in a regular basis as per the involvement of joints.

iii. Restriction of some risky movements has to be done like not to lift a heavy weight.

iv. A right posture has to maintain to prevent injury after consulting with a physiotherapist.

v. Regular moderate exercise has to be done to maintain normal actions of musculoskeletal system.

vi. A assistance has to provide with the client to help him to maintain basic needs and safety issues.

vii. All daily basic used articles has to put near the client so that he can easily access them.

Expected outcome = Impaired movement is reduced and basic needs is maintained for the client.