Ward E – ZDH

Room 221 – Alie, R. F./Alih, M. E.

Nanay Petra is a 65year-old seamstress, and is sitting on her sewing machine. Her reason for
scheduling this appointment was to ask for advice regarding ibuprofen or glucosamine with chondroitin
to help with “arthritis pain” in both her hands. From looking at her chart, you see that she has a BMI of
31 kg/m2, has hypertension and type 2 diabetes mellitus.

On examination, both of Nanay Petra’s hands appear normal (e.g., no deformities and no visible signs
of inflammation); however, Nanay Petra reports stiffness and pain (lasting for ~15-20 minutes) when she
first wakes up and after resting for prolonged periods. She has not missed any days from work, but
admits the pain is significantly worse compared to a year ago. When asked, Nanay Petra states she is
looking for pain relief and fears the arthritis “will spread” to her other joints. V/S T-36.8, P-78, R-22, Bp-
160/100mmHg.

She was given APAP(Acetaminophen) < 3 grams/day by her AP. While taking APAP, she was advised
to avoid taking other APAP containing products e.g. cough and cold remedies or any product claiming to
be aspirin free. It is important, however, to identify Nanay Petra’s risk factors and explain the
importance of self-management strategies.