Task #1: Care Plan for Arthritis
Arthritis is a common medical condition characterized by inflammation of one or more joints. The main symptoms include joint pain and stiffness, which tend to worsen with age. There are different types of arthritis, with osteoarthritis and rheumatoid arthritis being the most common. Osteoarthritis is often caused by normal wear and tear on the joints, while rheumatoid arthritis is an autoimmune disorder. Other types of arthritis can result from uric acid crystals, infections, or underlying diseases such as psoriasis or lupus.
When creating a nursing care plan for a patient with arthritis, it is essential to consider the specific needs and characteristics of the individual. The care plan should aim to alleviate pain, improve mobility, and enhance the overall quality of life for the patient. Here is an example of a nursing care plan that can serve as a guide:
1. Assessment:
– Assess the patient’s pain level using a pain scale or verbal cues.
– Observe the affected joints for signs of inflammation, redness, or swelling.
– Evaluate the patient’s mobility and range of motion.
– Assess the patient’s ability to perform activities of daily living.
– Review the patient’s medical history and any previous treatments for arthritis.
2. Diagnosis:
– Impaired physical mobility related to joint pain and stiffness.
– Chronic pain related to inflammation of the joints.
– Risk for falls related to decreased mobility and joint instability.
3. Planning:
– Collaborate with the patient to set realistic goals for pain management and mobility improvement.
– Provide education on joint protection techniques and exercises.
– Develop a plan to manage pain effectively, considering both pharmacological and non-pharmacological options.
– Implement strategies to prevent falls and promote safety.
4. Implementation:
– Administer prescribed medications to manage pain and reduce inflammation.
– Teach the patient exercises to maintain or improve joint flexibility and strength.
– Provide information on assistive devices, such as canes or walkers, if necessary.
– Encourage the patient to engage in low-impact activities, such as swimming or bicycling.
– Discuss the importance of maintaining a healthy weight to reduce stress on the joints.
– Collaborate with other healthcare professionals, such as physical therapists or occupational therapists, as needed.
– Provide emotional support and reassurance to the patient.
5. Evaluation:
– Regularly assess the patient’s pain level and functional ability.
– Determine if the patient’s mobility has improved or if pain management techniques are effective.
– Modify the care plan as needed to address any changes in the patient’s condition or goals.
It is important to note that this is just a general example, and the care plan should be individualized to meet the specific needs of each patient with arthritis.
Task #2: Case Study Questions on Medication History and Aging Effects
a. When conducting a medication history for an older adult, the nurse should ask the following questions:
– What medications are you currently taking? Include prescription, over-the-counter, and herbal supplements.
– How often and at what times do you take each medication?
– Have there been any recent changes in your medication regimen?
– Do you experience any side effects or adverse reactions from your medications?
– Are there any medications you have stopped taking and for what reason?
b. Older adults may be non-compliant with ordered medications for various reasons, including:
– Cost: Financial constraints may lead individuals to prioritize other expenses over medication costs.
– Adverse effects: Some medications may cause unwanted side effects that discourage adherence.
– Forgetfulness: Memory decline is common in older adults, increasing the risk of missed doses.
– Complex medication regimens: Taking multiple medications at different times can be confusing and difficult to manage.
– Lack of perceived benefit: If a patient does not think the medication is improving their condition, they may stop taking it.
– Beliefs and attitudes: Personal beliefs or cultural factors may influence an individual’s willingness to take certain medications.
c. Aging can affect several pharmacokinetic processes, including drug absorption, metabolism, distribution, and excretion:
– Absorption: Changes in the gastrointestinal tract, such as decreased blood flow and gastric emptying, can affect the rate and extent of drug absorption.
– Metabolism: Age-related changes in liver function can alter the rate at which drugs are metabolized, leading to increased or decreased drug levels in the body.
– Distribution: Age-related changes in body composition, such as a decrease in lean body mass and total body water, can affect drug distribution and drug efficacy.
– Excretion: Reduced renal function with aging can result in decreased drug clearance and prolonged drug half-life, leading to an increased risk of drug accumulation and toxicity.
It is important for healthcare providers to consider these age-related changes in pharmacokinetics when prescribing and administering medications to older adults. Dose adjustments and close monitoring may be necessary to ensure optimal therapeutic outcomes and minimize the risk of adverse drug effects.
