NURSING CARE

PLAN
SUBMITTED BY: SABAY, KYLE V.
01
RHEUMATOID
ARTHRITIS

NURSING CARE PLAN

 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

OBJECTIVE DATA Impaired physical SHORT TERM INDEPENDENT SHORT TERM

● Reluctance to mobility related to After 8 hours of nursing After 8 hours of nursing
attempt muscle weakness as interventions, the patient will: PROMOTE SAFETY MEASURES: To avoid injury, conserve energy, interventions, the patient:
movement/inability evidenced by limited ● gradually display ● Raise the bed rail and aid in maintaining balance. ● gradually displayed
to purposefully ROM, impaired increased strength ● Easy access to food and increased strength
move within the coordination, and and function of water and function of
physical reluctance to attempt affected and/or ● Provide adequate lighting affected and/or
environment movement compensatory body ● Remove obstacles from compensatory body
● Limited ROM part. travel path and place grab part.
● Impaired ● use appropriate bars ● used appropriate
coordination techniques, assistive ● Use of non-slip shoes techniques,
● Decreased muscle equipment, or both, to assistive equipment,
strength/control aid mobility. or both, to aid
and mass Continuously monitor the degree of Level of activity and exercise mobility.
joint inflammation and pain. depends on the progression and
LONG TERM resolution of the inflammatory
After 1 week of nursing process. LONG TERM
interventions, the patient will: After 1 week of nursing
● maintain a position of Schedule activities providing Systemic rest is mandatory during interventions, the patient:
function with frequent rest periods and acute exacerbations and ● maintained a
absence/limitation of uninterrupted nighttime sleep. important throughout all phases of position of function
contractures. disease to reduce fatigue, improve with
● maintain or increase strength. absence/limitation
the strength and of contractures.
function of the ● maintained or
Encourage patient to maintain Maximizes joint function,
affected and/or increase the
upright and erect posture when maintains mobility.
compensatory body strength and
sitting, standing, walking.
part. function of the
● participate in activities affected and/or
of daily living (ADLs) Assist with active and passive ROM Maintains and improves joint compensatory body
and desired activities. of affected joints function, muscle strength, and part.
general stamina. ● participated in
activities of daily
Promote the use of ambulatory Facilitates patient’s independence. living (ADLs) and
assistive devices (e.g., walker, cane, Proper transfer techniques prevent desired activities.
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION
INDEPENDENT
Encourage the patient to perform activities of daily living
(ADLs), such as practicing good hygiene, dressing and feeding
himself.
Position with pillows, sandbags, trochanter roll. Provide joint
support with splints, braces.
Provide foam or alternating pressure mattress.
Encourage patient to eat foods that includes the five major
groups (grains, green leafy vegetables, fruits, dairy, and protein)
and avoid inflammatory foods including sugar, deep-fried foods,
saturated fats, full-fat dairy, trans fats, refined carbohydrates,
alcohol, and preservatives like MSG.
DEPENDENT
Administer medications as prescribed.
Supplemental vitamins and minerals may also be prescribed as
needed.
COLLABORATIVE
RATIONALE EVALUATION
ADLs that can be done should be encouraged
to maximize function.
Promotes joint stability (reducing risk of
injury) and maintains proper joint position and
body alignment, minimizing contractures.
Decreases pressure on fragile tissues to
reduce risks of immobility and development
of decubitus.
For tissue building and repair. Correct
nutrition is necessary to keep sufficient
energy level.
Methotrexate is usually the first medicine
given to treat rheumatoid arthritis, often with
another DMARD and a short course of
steroids (corticosteroids).
Helps relieve arthritis symptoms such as pain
and stiffness.
02
OSTEOARTHRITIS

NURSING CARE PLAN

 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

OBJECTIVE DATA Activity intolerance SHORT TERM INDEPENDENT SHORT TERM

● Fatigue related to decreased After 8 hours of nursing After 8 hours of nursing
● Malaise muscle tone as interventions, the patient PROMOTE SAFETY MEASURES: To avoid injury, conserve energy, and interventions, the
● Limitation of evidenced by fatigue, will: ● Raise the bed rail, provide aid in maintaining balance. patient:
movement malaise, limitation of ● use identified handrails ● used
● Muscle atrophy movement, and muscle techniques ● Easy access to food and identified
● Overweight atrophy (e.g., use of water techniques
(BMI: 30) assistive ● Provide adequate lighting (e.g., use of
devices) to ● Remove obstacles from assistive
enhance travel path and place grab devices) to
activity bars enhance
intolerance. ● Use of non-slip shoes activity
● gradually intolerance.
display ● gradually
increased Monitor joint swelling and promote Joints often swell with stress such as displayed
strength and RICE. walking or with an injury. Remember increased
function of RICE: Rest, Ice, Compression, strength and
affected Elevation function of
and/or affected
compensatory Assist with active and passive ROM ROM activity loosen joints and prevent and/or
body part. exercises. stiffness. compensator
y body part.
LONG TERM
Assist with ADLs while avoiding client Assisting the patient with ADLs allows
After 2-3 days of nursing LONG TERM
dependency. conservation of energy. Carefully
interventions, the patient After 2-3 days of
balance provision of assistance;
will: nursing interventions,
facilitating progressive endurance will
● report a the patient will:
ultimately enhance the patient’s
measurable ● reported a
activity tolerance and self-esteem.
increase in measurable
activity increase in
intolerance. Encourage weight loss and exercises These are important approaches to activity
such as walking begun moderately and lessen pain and disability. intolerance.
increased gradually.
GOAL MET.
Promote the use of ambulatory Facilitates patient’s independence.
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

INDEPENDENT

Position with pillows, sandbags, trochanter roll. Provide joint Promotes joint stability (reducing risk of injury) and
support with splints, braces. maintains proper joint position and body alignment,
minimizing contractures.

Provide foam or alternating pressure mattress. Decreases pressure on fragile tissues to reduce risks of
immobility and development of decubitus.

Encourage patient to eat foods that includes the five major For tissue building and repair. Correct nutrition is
groups (grains, green leafy vegetables, fruits, dairy, and necessary to keep sufficient energy level.
protein) and avoid inflammatory foods including sugar, deep-
fried foods, saturated fats, full-fat dairy, trans fats, refined
carbohydrates, alcohol, and preservatives like MSG.

DEPENDENT

Administer medications as prescribed. To relieve signs and symptoms of arthritis.

Supplemental vitamins and minerals may also be prescribed Helps relieve arthritis symptoms such as pain and
as needed. stiffness.

COLLABORATIVE

Refer the patient to physiotherapy / occupational therapy team To provide specialized care for the patient in increasing
daily physical activity.
03
GOUT ARTHRITIS

NURSING CARE PLAN

 ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

OBJECTIVE DATA Self-Care deficit: SHORT TERM INDEPENDENT SHORT TERM

● Joint feeding, bathing, After 8 hours of nursing
inflammation dressing, and/or interventions, the patient
and stiffness toileting related to will:
● Tenderness of musculoskeletal ● identify
the joint impairment and pain personal/commun
● Decreased as evidenced by joint ity resources that
strength inflammation, stiffness can provide
● Limited range and tenderness, needed
of motion decreased strength, assistance.
● Inability to limited ROM, ● identify individual
perform desired inability to perform areas of weakness
ADLs and desired ADLs and or needs.
maintain maintain physical care ● gradually perform
physical care self-care activities
within level of own
ability.
LONG TERM
After 3 days of nursing
interventions, the patient
will:
● perform self-care
activities at a level
consistent with
individual
capabilities.
● demonstrate
techniques/lifestyl
e changes to meet
self-care needs.
After 8 hours of nursing
Identify degree of individual impairment Prepares for increased independence, interventions, the
and functional level. Identify barriers to which enhances self-esteem. patient:
participation in self-care. Identify and ● identified
plan for environmental modifications. personal/commu
nity resources
that can provide
Maintain mobility, pain control, and Support physical and emotional needed
exercise program. independence. assistance.
● identified
individual areas
Monitor joint swelling and promote Joints often swell with stress such as of weakness or
RICE. walking or with an injury. Remember needs.
RICE: Rest, Ice, Compression, ● gradually perform
Elevation self-care
activities within
Assist with active and passive ROM ROM activity loosen joints and prevent level of own
exercises. stiffness. ability.
LONG TERM
Assist with ADLs while avoiding client Assisting the patient with ADLs allows
After 3 days of nursing
dependency. conservation of energy. Carefully
interventions, the
balance provision of assistance;
patient:
facilitating progressive endurance will
● performed self-
ultimately enhance the patient’s
care activities at
activity tolerance and self-esteem.
a level consistent
with individual
Allow patient sufficient time to May need more time to complete capabilities.
complete tasks to the fullest extent of tasks by self but provides an ● demonstrated
ability. Capitalize on individual opportunity for a greater sense of techniques/lifesty
strengths. self-confidence and self-worth. le changes to
meet self-care
Promote the use of ambulatory Facilitates patient’s independence. needs.
assistive devices (e.g., walker, cane, Proper transfer techniques prevent
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

INDEPENDENT

Position with pillows, sandbags, trochanter roll. Provide joint support Promotes joint stability (reducing risk of injury) and maintains
with splints, braces. proper joint position and body alignment, minimizing contractures.

Provide foam or alternating pressure mattress. Decreases pressure on fragile tissues to reduce risks of immobility
and development of decubitus.

Nutrition Education: Dietary changes reduce the risk of recurrent gout attacks and
● Restrict consumption of foods high in purines or animal lessen the severity of future attacks. Patients should avoid foods
proteins (liver, kidney, beef, lamb, and pork) and seafoods high in purines as these will cause a buildup of uric acid within the
such as shellfish, sardines, and tuna body.
● Encourage foods that reduce the risk of attacks including
coffee, cherries, and foods high in vitamin C
● Limit or avoid foods/drinks sweetened with fructose

DEPENDENT

Administer medications: NSAIDs / Corticosteroids, Colchicine, Xanthine Medications can help relieve the immediate symptoms while
Oxidase Inhibitors (XOIs), Uricosurics, as prescribed. others are for long term management and prevention of flare-up
recurrence.

COLLABORATIVE

Consult with rehabilitation specialists (occupational therapist). Helpful in determining assistive devices to meet individual needs
(buttonhook, a long-handled shoe horn, reacher, hand-held shower
head).

Arrange a home-health evaluation before discharge, with follow-up Identifies problems that may be encountered because of the
afterward. current level of disability. Provides for more successful team
REFERENCES
● Doenges, Marilynn E, Mary F. Moorhouse, and Alice C. Murr. Nurse's Pocket Guide:
Diagnoses, Prioritized Interventions, and Rationales. Philadelphia, PA: F.A. Davis,
2019. Print.
● Matt, V. (2022 March 18). 6 Rheumatoid Arthritis Nursing Care Plans.
https://nurseslabs.com/6-rheumatoid-arthritis-nursing-care-plans/4/
● Paul, M. (2022 March 18). 4 Osteoarthritis Nursing Care Plans.
https://nurseslabs.com/osteoarthritis-nursing-care-plans/