Community Health Nursing Case Study

Activity 2: Case Study

Select one theory in health promotion and apply it to the situation stated
below. How will you apply the theory bearing in mind the concept it
presented. Base your output in the rubric provided.

A community health nurse visits an elderly client who lives alone and is restricted to bed
because of pain in his joints due to osteoarthritis. During conversation, the nurse finds
that the client feels sad and inadequate due to his disability.

CATEGORY 4 3 2 1
Organization Information is very Information is Information is The information
organized with well- organized with well- organized, but appears to be
constructed constructed paragraphs are not disorganized.
paragraphs and paragraphs. well-constructed.
subheadings.
Quality of Information clearly Information clearly Information clearly Information has little

Information relates to the main relates to the main relates to the main or nothing to do with
topic. It includes topic. It provides 1-2 topic. No details the main topic.
several supporting supporting details and/or examples are
details and/or and/or examples. given.
examples.
Application of Theoretical concepts Theoretical concepts Theoretical concepts Theoretical concepts
theoretical are clearly defined are defined and are not clearly are not clearly

concepts and applied somewhat applied defined and defined and applied
minimally applied

Diagrams & Diagrams and Diagrams and Diagrams and Diagrams and

Illustrations illustrations are neat, illustrations are illustrations are neat illustrations are not
accurate and add to accurate and add to and accurate and accurate OR do not
the reader\'s the reader\'s sometimes add to the add to the reader\'s
understanding of the understanding of the reader\'s understanding of the
topic. topic. understanding of the topic.
topic.
Notes Notes are recorded Notes are recorded Notes are recorded. Notes are recorded
and organized in an legibly and are only with
extremely neat and somewhat organized. peer/teacher
orderly fashion. assistance and
reminders.

INTRODUCTION:
Osteoarthritis sometimes called wear and tear arthritis is the most common type of arthritis.
When the smooth cushion between bones (cartilage) breaks down, joints can get painful,
swollen and hard to move. OA can affect any joint, but it occurs most often in hands, knees,
hips, lower back and neck. OA can happen at any age, but it commonly starts in the 50s and
affects women more than men. Risk factors that contribute to OA are age, joint injury,obesity,
weak muscle, genes and sex. The symptoms usually build over time rather than show up
suddenly. OA may may affect the different part of our body but commonly in hands, feet,
knees and hip. As OA gets worse, cartilage may get uneven edges and cracks. Bones may
harden, change shape and get bumpy. Once cartilage breaks down, it doesn’t grow back on
its own. (arthritis.org)

I. Assessment Level

J.B. is a 73 year old widowed woman that lives in Barangay Paglaum,Binalbagan Negros
Occidental. J.B. lives alone due to the reason that her children have its own family and she
doesn’t want to be a burden to her children. She finished high school level and a devoted
woman in her beliefs.J.B.’s daughter in abroad is the one that supports her needs and she
receive the money directly and the one who manage it to meet her basic necessities. J.B.
lives in a congested area and neighborhood but inside her house was spacious.She own a
water and electricity supply, puts her garbage in a trashcan and a man made drainage
system. Upon observation, the nurse notices the presence of possible hazard in her house,
the presence of upper and lower floor with 15 inches width and the tiles in her comfort room.
The distance of health care facility from their house is about 250 meters away when walking
and they offer a daily consultation and free medicines if available. During interview, J.B.
complains for her recent joints and back pain due to osteoarthritis and is restricted in her bed.
She describes her feeling about her problem and it feels like a sharp ache and gets worse
every time she accompany with her daily task, she rates her pain as 6/10. She also feel sad
about her condition and vulnerability.Through gathering her history, the nurse found out that
J.B.’s family has an hereditary of osteoarthritis, hypertension, anemia and stroke. J.B. was
diagnosed for dehydration and nervous breakdown when she was 40 years old, and she also
stumble at age of 45 years old and have 7 stitches.Since she’s old and lives alone,she
develops a sedentary lifestyle, she didn’t exercise at all, poor eating habit that also
contributes in her recent illness.

II. Diagnosis
Inability to make decisions with respect to taking appropriate health action due to failure to
comprehend the nature of the condition,feeling of helplessness, inadequate knowledge as to
alternative courses of action to take and physical inaccessibility of appropriate resources for
care.
III. PLANNING
The following treatment plan is determined to this client by the use of Health Belief Theory;
the community health nurse expects the client to participate and comprehend the nature
osteoarthritis and its condition, the perceived susceptibility and severity of it, the benefits gain
in changing the current behavior and identifying barriers that hinders the client in changing its
behavior and the contributing factors that causes osteoarthritis, to gain knowledge about the
disease and create a precaution to prevent further conflicts, improved self-esteem, regain
strength and function of the body parts, and perform its activities of daily living (ADL).

Nursing Intervention:

 Assess the client knowledge and understanding about osteoarthritis

 Assess client’s readiness to learn and participate on activities/care given

 Monitor vital signs and assess client’s level of pain

 Help client to increased self-esteem and self-worth by providing therapeutic

communication and improved physical health

 Make an activity that promote client’s function and independence

 Promote adequate rest and reduction of stress

 Provide health teaching about osteoarthritis

 Massage surrounding muscles,not over inflamed joints

 Position client to prevent flexion deformity using a footboard, splints, sandbags or

wadges, or pillow as needed. Remove splints routinely, if used, to exercise joints.

 Evaluate client’s response and improvement to nursing interventions provided

 IV. IMPLEMENTATION

J.B.’s Perception Modifiable Factors Likelihood of Actions

1. Mrs. J.B. 73 year old,female Perceive benefits of preventive

actions
2. Middle Class
Minus
3. Physical Inactivity
Perceived barriers to preventive
4. History of Osteoarthritis action

Mrs. J.B. is suffering from her

knee and back osteoarthritis for Likelihood of taking
the last 8 years and it gets Perceived threat of recommended preventive health
worsen from time to time. worsening her knee and action
She understand the underlying back osteoarthritis
cause of her disease and
participate in improving her
health condition.

She shows a gradual Cues to Action

improvement in her self and
slowly being independent The nurse explains the risk of
worsening the osteoarthritis
Follows the instructions given to
alleviate pain and discomfort. Contact a Barangay Health

Learns to massage the

surrounding part of the affected

V. EVALUATION

After nursing intervention, the goal towards the client’s condition and whole being were met and
the client is able to:

 Perform her activities of daily living independently.

 Gain knowledge and understand about her disease condition.

 Improved self-esteem.