- Chronic Pain related to Joint stiffness and Bone deformities as evidenced by facial grimacing and hesitancy to move joints
- Deficient Knowledge related to Inadequate access to resources as evidenced by
Inaccurate follow-through of instructions and poor adherence to therapy or exercise - Impaired Physical Mobility related to restricted joint movement and Inflammatory process as evidenced by decreased range of motion and engages in substitutions for movement
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Expression from the patient about pain Objective data: -Diaphoresis -Distraction behavior -Expressive behavior -Facial grimacing -Reports pain intensity -Hesitancy to move joints | Chronic Pain related to Joint stiffness and Bone deformities as evidenced by facial grimacing and hesitancy to move joints | The patient will report pain relief and comfort The patient will demonstrate two strategies to reduce pain | 1. Apply a hot or cold compress for 30 minutes. Heat improves blood flow and reduces pain reflexes. Cold can help reduce inflammation, pain, and muscle elasticity. Each patient may prefer one over the other. 2. Take breaks. Joint pain with OA often worsens with activity and lessens with rest. The patient may need to take breaks when working, exercising, or completing tasks. 3. Administer oral and topical pain relief. NSAIDs are recommended for OA pain. Over-the-counter topical creams and gels such as diclofenac are commonly used to relieve arthritic pain. 4. Consider injections. Cortisone injections injected into the joint space can relieve pain temporarily for a few weeks. Lubrication injections that use hyaluronic acid may help cushion the joints. 5. Instruct on a TENS unit. Transcutaneous electrical nerve stimulation sends low-voltage currents to the area around the joint to provide short-term relief. | The patient reported pain relief and comfort The patient demonstrated two strategies to reduce pain |
| Subjective data: Verbalizes poor understanding Seeks additional information Objective data: -Inaccurate demonstration or teach-back of instructions -Inability to recall instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge related to Inadequate access to resources as evidenced by Inaccurate follow-through of instructions and poor adherence to therapy or exercise | The patient will explain the disease process and the necessity of the treatment regimen The patient will adhere to the treatment regimen and exhibit improved symptoms, as evidenced by reduced pain and stiffness and a more active lifestyle | 1. Reinforce patient education through frequent repetition and follow-up sessions. Frequent and regular education sessions promote medication and self-care management adherence with improved outcomes. 2. Educate the patient about proper medication use. NSAIDs are commonly prescribed in the treatment regimen of osteoarthritis but can have side effects if taken incorrectly. Proper timing, dosage, and use of medications should be provided to the patient. 3. Educate on supplements. If prescribed by the provider, the nurse can educate the patient on supplements for joint health. These often include collagen, glucosamine, and chondroitin. 4. Encourage the use of devices. The nurse can educate the patient on devices to make everyday activities easier. Electric can openers and large-handled utensils can reduce stress on finger joints. Rubber grips on knobs and handles can make turning easier. Gloves and knee/elbow sleeves can keep joints aligned for better mobility. | The patient explained the disease process and the necessity of the treatment regimen The patient adhered to the treatment regimen and exhibit improved symptoms, as evidenced by reduced pain and stiffness and a more active lifestyle |
| Subjective data: Expression of pain and discomfort with movement Refusal to move Objective data: -Limited range of motion -Poor balance -Inability to turn in bed, transfer, or ambulate -Postural instability -Reliance on assistive devices -Decreased muscle strength | Impaired Physical Mobility related to restricted joint movement and Inflammatory process as evidenced by decreased range of motion and engages in substitutions for movement | The patient will perform activities without discomfort and with minimal supervision The patient will participate in therapy and exercise to improve mobility | 1. Encourage the use of assistive devices. The correct use of assistive devices can help improve the patient’s mobility, promote safety, and reduce the risk of injury. 2. Encourage the patient to increase activities as tolerated. The patient may be hesitant to participate in exercise that can cause pain, but increasing activity can help improve and maintain joint function and independence. The patient can partake in low-impact activities like swimming and biking, which may be easier on joints. 3. Refer the patient to physical therapy. A physical therapist can help formulate an exercise program addressing the immobility and joint dysfunction of the patient. 4. Refer the patient to community resources. Local gyms or clubs may offer “joint-friendly” classes such as chair yoga or water aerobics that also provide socialization. | The patient performed activities without discomfort and with minimal supervision The patient participated in therapy and exercise to improve mobility |