Task #1: Care Plan for a Patient with 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 the two most common being osteoarthritis and rheumatoid arthritis.
Osteoarthritis is typically caused by normal wear and tear on the joints, while rheumatoid arthritis is an autoimmune disorder. There are also other types of arthritis that can be caused by uric acid crystals, infections, or underlying diseases such as psoriasis or lupus.
When creating a care plan for a patient with arthritis, it is essential to consider various factors that can affect their overall health and well-being. The goal of the care plan is to manage pain, improve joint function, and enhance the patient’s quality of life.
To begin the care plan, a comprehensive assessment of the patient is necessary. This assessment should include gathering information about the patient’s medical history, current medications, physical limitations, and specific symptoms related to their arthritis.
In addition to the medical assessment, a nursing assessment should be conducted to determine the patient’s functional abilities, activities of daily living, and any potential psychosocial or emotional factors that may impact their condition.
Based on the assessment findings, the following nursing diagnoses and interventions can be included in the care plan:
1. Impaired physical mobility related to joint pain and stiffness:
– Teach the patient proper body mechanics and joint protection techniques
– Encourage regular exercise and physical therapy to improve joint flexibility and strength
– Assist the patient with adaptive equipment, such as walkers or canes, if necessary
2. Chronic pain related to inflammation and joint damage:
– Administer prescribed pain medications as ordered and monitor their effectiveness
– Apply heat or cold therapy to alleviate pain and reduce inflammation
– Teach relaxation techniques and distraction methods to manage pain
3. Risk for falls related to impaired physical mobility and joint instability:
– Assess the patient’s environment for potential fall hazards and make necessary modifications
– Encourage the use of assistive devices, such as handrails and non-slip mats
– Provide education on fall prevention strategies and promote independence
4. Impaired self-care related to limitations in joint function:
– Assist the patient with activities of daily living, such as bathing and dressing
– Teach energy conservation techniques to minimize joint strain
– Collaborate with occupational therapists to provide adaptive equipment for self-care tasks
5. Anxiety related to uncertainty about the future course of the disease:
– Provide emotional support and reassurance to the patient and their family
– Offer education about the nature of arthritis, its treatment options, and prognosis
– Refer the patient to support groups or counseling services, if needed
It is important to regularly evaluate the effectiveness of the care plan and make adjustments as needed. Collaboration with the interdisciplinary healthcare team, including the patient’s physician, physical therapist, and occupational therapist, is crucial for comprehensive and coordinated care.
Task #2: Case Study – Health Care of the Older Adult
The nurse is completing the admission assessment for a patient scheduled for cataract surgery in the outpatient center. The patient is over the age of 70 and has several chronic conditions, including hypertension and congestive heart failure. The nurse focuses on completing a thorough medication history.
a. When gathering the medication history, the nurse should include the following questions:
– What medications are you currently taking?
– Are you taking any over-the-counter medications, vitamins, or herbal supplements?
– How often do you take each medication?
– Are you experiencing any side effects from your medications?
– Have you ever had an allergic reaction to any medications?
– Have you had any recent changes in your medications or dosages?
b. Older adults may be non-compliant with ordered medications for various reasons, including:
– Cost: Some medications may be expensive, and older adults may struggle to afford them, leading to non-compliance.
– Side effects: Some medications may cause adverse effects that older adults find intolerable, leading them to stop taking the medication.
– Complexity: The number of medications and their dosing schedule can be overwhelming for older adults, leading to confusion and non-compliance.
– Lack of understanding: Older adults may not fully understand the importance of their medications or the potential consequences of not taking them.
– Cognitive impairment: Memory problems or dementia can make it difficult for older adults to remember to take their medications as prescribed.
c. Aging can affect drug absorption, metabolism, distribution, and excretion. As people age, changes in their bodies can influence how medications are processed:
– Absorption: The absorption of medications through the gastrointestinal tract may be slower in older adults, leading to delayed onset of action.
– Metabolism: The liver’s ability to metabolize medications may decline with age, resulting in slower drug metabolism and longer drug half-lives.
– Distribution: Changes in body composition, decreased blood flow, and reduced protein binding can affect how medications are distributed in the body.
– Excretion: Kidney function tends to decline with age, which can lead to a slower drug clearance rate and increased drug accumulation.
These age-related changes can increase the risk of medication side effects and drug-drug interactions in older adults. Therefore, healthcare providers must carefully assess and monitor medication use in older adult patients to ensure optimal safety and effectiveness.
