Question

In: Nursing

Write and submit a nursing care plan; 1) One from the musculoskeletal diagnosis

Write and submit a nursing care plan;

1) One from the musculoskeletal diagnosis

Solutions

Expert Solution

Let us take an example of rheumatoid arthritis

The common problems/needs are

  • pain
  • inability to walk
  • inability to meet their needs
  • feels bad/disturbed about the body imaGE
  • difficulty in adhering to the treatment regimen

The possible nursing diagnosis are

  • acute pain
  • impaired physical mobility
  • self care deficit
  • disturbed body image
  • non compliance
  • anxiety
  • knowledge deficit
  • risk for comnplications

1. Acute pain

Assessment

subjective data: patient may complain of pain;

Objective data: look for dullness, sad face, irritable look/talk, pain score:---/10

Goal: patient's level of pain is minimised

Nursing Interventions with rationale:

  • Assess the level of pain - to plan the care
  • position the patient comfortably - to promote comfort
  • provide comfort device- to reduce the direct pressure
  • provide divertional therapy in varioous forms like music, reading /listening to news - to divert the mind from thinking about pain
  • apply hot / cold applications as per order if there are no contra indications - to reduce joint stiffness
  • advice/ allow a close relative to be with the patient - to divert from thinking about pain
  • administer analgesics as per order - to reduce the pain

Evaluation

  • The patient's pain level has reduced from ---- to -----

2. Impaired physical mobility

Assessment

  • Subj. data - patient may complain of inability to walk
  • obj.data - patient's level of activity is restricted; inability to carry out daily activities, inability to perform gross / fine motor activities

Nursing diagnosis - Impaired physical mobility

Goal - patient's level of mobility is improved

Nursing Interventions

  • Assess the level of mobility - bed mobility, supported and unsupported sitting , transition movements like turning etc - to plan the care
  • monitor and record client's abiolity to tolerate activity - to provide activity
  • observe for and treat pain before activity - to enhance the activity level
  • perform passive ROM or teach active ROM as per need - to improve the activity level
  • offer any assistive devices as per need - to help in mobility
  • use a walking belt if needed when ambulating - to prevent injury
  • set achievable goals - to enhance sense of participation
  • gradually improve the levelof activity - to improve tolerance

3.


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