WABINGA, SHYN MARGARETH B.

NUR 151: COA

BSN 3- A5 SAS 23: CASE STUDY B
RHEUMATOID ARTHRITIS

Assessment Data Nursing diagnosis Goals Nursing Interventions Rationale Evaluation

Subjective Data: Acute and chronic Short-Term Goals: Independent: Independent: Client is
1. Has painful, stiff pain related to joint 1. Client will report 1. Consider reports of 1. Favorable in relieved from
hands and feet inflammation as relieved/controlled pain, noting location determining pain pain.
evidenced by
2. Feels tired all of painful, still hands
of pain. and intensity (scale management needs
the time and feet. 2. Client will appear of 0–10). Note and effectiveness of Client will be
3. Reports an relaxed, able precipitating factors the program. able to
intermittent low- to sleep /rest and and nonverbal pain 2. Soft and sagging perform her
grade fever participate in cues. mattress, large pillows daily
4. Takes naproxen activities 2. Recommend or prevent maintenance activities.
(Aleve) 220 mg appropriately. provide a firm of proper body
twice daily 3. Client will follow mattress or bed- alignment, placing Client is able
5. Wears a copper the prescribed board, small pillow. stress on affected to sleep and
bracelet on the pharmacological Elevate linens with joints. Elevation of rest well.
advice of a regimen. bed cradle as needed. bed linens reduces
neighbor 3. Place and monitor pressure on inflamed Client
Long Tern Goals: use of pillows, or painful joints. manifests
Objective Data: 4. Client will sandbags, trochanter 3. Rests painful joints relaxation
incorporate rolls, splints, braces. and maintains a skills and
1. Hands show mild relaxation skills 4. Encourage frequent neutral position diversional
ulnar drift and and diversional changes of position. 4. Prevents general activities
puffiness activities into the Assist the patient to fatigue and joint whenever she
2. Temp: 100°F pain control move in bed, stiffness. Stabilizes feels pain.
(37.8°C) program. supporting affected joint, decreasing joint
3. Admitted to the joints above and movement and
hospital for below, avoiding associated pain.
examination and jerky movements. 5. Duration more
comprehensive 5. Monitor the duration, accurately reflects the
treatment plan not the intensity, of disease’s severity.
4. Methotrexate morning stiffness. 6. Promotes relaxation,
(Rheumatrex)
6. Encourage the use of provides a sense of
stress management control and may
therapy to be techniques such as enhance coping
initiated progressive abilities.
relaxation,
biofeedback, Dependent:
visualization, guided 1. Promotes relaxation,
imagery, self- reduces muscle
hypnosis, and tension and spasms,
controlled breathing. facilitating
Provide participation in
Therapeutic Touch. therapy.
2. ASA exerts an anti-
Dependent: inflammatory and
1. Medicate before mild analgesic effect,
planned activities decreasing stiffness
and exercises as and increasing
indicated. mobility.
2. Administer These drugs control
medications as mild to moderate pain
indicated: and inflammation by
Nonsalicylates inhibition of
Aspirin (ASA) prostaglandin
DMARD synthesis.
3. Apply ice or cold These drugs vary in
packs when action, but all reduce
indicated. pain and swelling,
lessening arthritic
Collaborative: symptoms rather than
1. Assist with physical eliminating them.
therapies such 3. Cold may relieve pain
as paraffin glove, and swelling during
whirlpool baths. acute episodes
2. Instruct in use and
monitor the effect of Collaborative:
transcutaneous 1. Provides sustained
electrical nerve heat to reduce pain
stimulator (TENS) and improve ROM
unit if used. of affected joints.
WABINGA, SHYN MARGARETH B. NUR 151: COA
BSN 3- A5 SAS 23: CASE STUDY B
RHEUMATOID ARTHRITIS
2. Constant low-level
electrical stimulus
blocks the
transmission of pain
sensations.

SUBMITTED TO: MR. GELBERT JAN S. PORQUE