Plan of Care for Osteoarthritis Patient

This document discusses the plan of care for a patient with osteoarthritis, including assessment, nursing diagnosis, implementation, rationale, and evaluation. It also provides information on the importance of pharmacological and non-pharmacological therapies in reducing pain.

Assignment 1, part 1
PLAN OF CARE
PATIENT or NURSING
ORIENTED PROBLEM
OR PATIENT NEED
PATIENT ASSESSMENT
DATA
OPTIMAL PATIENT
OUTCOME or GOAL
1.
The primary assessment of
the patient was the problem
at the knee due to
osteoarthritis. The patient
was not able to stand the
pain.
The patient was suffering
from osteoarthritis in the
left knee therefore this
caused pain and affected
the mobility of the patient.
After operation he was
suffering from pain at the
incision site.
GCS 15, PERL. Pain score -
left knee 5/10
The disease osteoarthritis is a
disease of the bones which
most of the time leads to the
elevation of the risk of the
fractures. There are situations
where the patient often
suffers a chance of breaking
a bone, therefore the patient
is often considered to be
fragile. There are chances of
typical fragility especially in
the knee in the given
situation.
Actions should be taken to
verbalise the decrease or the
absence of the pain. It should
be decreased from 5/10 to
0/10.
It was required to verbalise
the understanding of the
importance of the
significance of both the
pharmacological and the
pharmaceutical therapies in
order to decrease the pain.
It is important to maintain
the integrity of the skin
around the wound area which
is evidenced by the lack of
the pressure ulcer
development (Gulanick &

Myers 2016). Being free
from any kind of injury.
Making the patient verbalize
regarding the absence of the
pain which is experienced
upon moving.
It is important to demonstrate
the relaxation techniques
along with the activities of
diversion for the aim of
decreasing the pain.
It is important to increase the
comfort of the patient and to
decrease the pain
experienced by the patient.
2.
He felt nauseated and was
shivering out of the pain.
RR 27, Sp02 94% on 60%
oxygen, equal air entry –
chest is clear. Verbal report
of feeling a little breathless.
Glucose 5.1. Nil hx diabetes.
Due to the surgery there was
a pain at the incision site
since there were plates and
screws inserted in order to
stabilise the tibia which is a
The patient will be able to
participate in the activities of
daily life along with the other
desired activities.
The patient will be made to
show willingness to
participate in the
interventions which will help

part of the procedure. the patient in improving the
conditions of mobility.
The patient needs to
verbalize the absence of the
back pain.
It is important to verbalize
about the significance of the
both pharmacological and the
non-pharmacological
therapies in order to reduce
the prevalence of the pain.
The patient should stay safe
from any injury.
3.
The wound site appeared to
be sutured and the skin at
the wound site appeared.
The assessment showed that
wound site is left knee,
sutures in situ, skin appears
‘tight’, swollen, shiny and
red. Warm to touch. Several
areas of dehiscence with pus
present.
It is important to report the
increase in the comfort along
with the reduction of the pain
at the injury site.
It is important to verbalize
the patient regarding the
education and the health
teachings that needs to be
imparted to the prevention of
the additional injury
(Dunphy et al. 2015).
.

4.
The patient was not able to
stand up without any
provided assistance.
Impairment of the physical
mobility and prevalence of
discomfort in the knee
area. Pain was experienced
on any movement. There
was some kind of guarding
behaviour as well.
IV cannula inserted. After
the surgery, there was
occurrence of an uneventful
post-operative period after
which the patient was
discharged after two days.
The patient was also given
anti-inflammatory
medication for pain relief.
The patient is able to
participate in the activities
which are applicable to the
real life situations in order to
enhance the change.
It is also required to show the
changes in the behavior in
order to restore a positive
self-image.
5.
The patient was perceived
to be unhealthy since the
scale showed 5/10. Risk for
development of any injury
like a fracture due to the
impact of the change in the
structure of the bone that is
secondary to the
osteoarthritis.
There was altered ADL
which was shown by the
It is important to make sure
to report the lack of the
complications that occurs
due to the lack of the
mobility. After a few hours
of nursing interventions, it
was required to the
maintainence the lack of the
chances of the additional
fractures.

patient.
6.
Deficit of self-care. Deficit
of the activities like the
toileting and bathing as a
result of the pain along
with the discomfort on
moving the body.
Problem in mobility, was
fitted with a supportive knee
brace. There are non-weight
bearing on crutches which
were also provided to the
patient.
The patient must try to
perform the self-care
activities while keeping the
level within one’s own
identity.
It is required to express
positive feelings towards the
patient while one is trying to
carry out the activities.
Within few hours of the
nursing interventions the
patient must be able to
verbalize the elevation of the
level of sense of the self-
worth that is in relation to the
current situation of the
patient (Eliopoulos 2013).
Assignment 1, part 2
ASSESSMENT/NURSING DIAGNOSIS/OUTCOME
IMPLEMENTATION RATIONALE EVALUATION

It is important to assess the
pain experienced by the
patient which needs to
include the location of the
pain along with the
characteristics and the
intensity of the pain. The
frequency, quality along with
the aggravating factors of
pain is also important. This
requires the use of the pain
scale 0-10.
It is important to assess the
description of the pain.
It is important to obtain the
subjective data related to the
pain which includes the feelings
of the patient. It also rules out
the underlying condition and the
conditions that are related to the
development of the
complications.
For the purpose of obtaining the
baseline data, it is required to
alter the data during the acute
pain.
For the aim to decrease the pain
sensation by implementing the
non-pharmacological
approaches.
In order to provide comfort to
the patient and to decrease the
pain.
In order to distract the attention
of the patient from the pain and
also to reduce the pain.
For reducing the pain and to
The evaluation involves
to see whether the goals
are partially met or fully
met.
The evaluation showed
that patient was able to
verbalize the reduction
in the sensation of pain
while the patient was
taking the medication.
The patient was able to
show the techniques
which are non-
pharmacological in
nature with the
assistance from the S.O.

prevent any other injury from
occurring.
For making the patient mobilise
and to support the lumbar
portion of the patient while the
patient is moving.
Client might report pain present
in the fingers, the hips and the
knees along with the vertebrae.
This pain is most of the time
provoked by activity and then it
is relieved by the rest. There is
also joint pain and aching which
might be present (Dziedzic et al.
2014).
.
The skin colour of the wound
area also needs to be
The supplements like the
calcium and vitamin D is
The patient was able to
implement the activities

monitored. important for the process of
bone formation and also to
increase the bone density and
the bone mass.
In order to prevent the patient
from having any pressure from
ulcers.
For the purpose of aiding a
faster healing of the patient.
Assisting the patients with the
activities of the daily life which
will allow the conservation of
the energy. It is required to
provide balance carefully along
with the provision of assistance,
thereby facilitating the
endurance which will ultimately
help in enhancing the tolerance
activity of the patient along with
self-esteem.
Exercises might help in the
maintaining the strength of the
muscle thus increasing the
along with the help and
assistance received from
the nurses and when
there is absence of the
pain.

tolerance of the exercise.
It is important to provide
measures of comfort to the
patient like providing
backrubs, also the provision
of heat packs and cold packs
to the area that is affected.
The patient should be
encouraged to have a
complete bed rest. He should
be provided with linens
along with a non-sagging and
form mattress to sleep on.
The patient should also be
encouraged to perform
activities related to relaxing
or exercises like the deep
breathing exercises.
The patient should also be
suggested to move his trunk
as a whole unit in order to
avoid twisting. Assistance
should be given to the patient
Provides stability to the
reduction of the possibility of
disturbing alignments along
with muscle spasms and
therefore enhance healing.
However excessive bed rest
might lead to more
complications including
problems like constipation and
contractures. Providing a firm
mattress might help in
increasing the comfort of the
patient.
Helps to maintain the adequate
the urine output and therefore
the following should be avoided
like hypercalcluria, renal calculi
and hypercalcemia.
Application of a lumbosacral
corset or binder is also
suggested.
The patient was free
from any kind of signs
of pressure ulcers and
which was free from any
other injuries.
The patient was able to
maintain an intact skin
integrity in the wound
area.
The patient was
successful in verbalising
the reduction in the
sensation of pain while
he was feeling
comfortable.
Whether the patient was
able to express his
feelings without

during turning sides.
The patient should be
encouraged to take
adequately balanced diet
which is rich in calcium and
phosphorous along with
vitamin D. food items like
milk, egg and others needs to
be given to the patient.
Medication therapies are
required to be provided
which included the
medications like NSAID,
Ventolin, Seretide accuhaler.
Additionally it is required to
determine the degree of
immobility that is related to
the assessment of the pain.
The emotional and the
behavioural response of the
patient towards the problem
of immobility is also
important.
The patient should be
Prevents the patient from
developing pressure ulcers.
When the patient is present at
home, additional injuries can be
avoided. Provide balance to the
patient and prevent injuries.
The vitamin, calcium and others
are essential for the patient.
It is important to encourage the
patient to perform a knee
flexion in order to avoid injury.
The patient should also be
encouraged to install the safety
devices like the grab bars and
the side rails and railings at
home after the discharge in
order to avoid falls and other
additional injuries.
A liberal intake of calcium and
fluid intake is suggested along
with the intake of the
supplements.
The patient should be assisted to
hesitation.
Was the patient able to
accept the present
condition or not and
identify the problems
that he was going
through (Brand,
Ackerman & Tropea
2014).

encouraged to increase the
fluid intake 2000-3000ml a
day which is within the
cardiac tolerance.
turn the sides every 2 hours.
It is also important to evaluate
the indicators like the reduction
in the ability to ambulate and to
move purposefully keeping
shorter keeps and making the
appearance of the gait. There is
also uneven weight bearing
along with an observable limp
due to the injury in the knee
(LeMone et al. 2015).
Promotes the patient to trust a
given situation in which the

patient is able to exist freely and
to be open and honest with
one’s self. Helps the patient to
identify the underlying reasons
of dependency and help the
patient to cope with it. Increases
the likelihood of receiving an
appropriate support to the
patient. This also helps to make
the patient feel better while they
are able to present an outer
appearance that is positive in
nature.
References
Brand, C.A., Ackerman, I.N. & Tropea, J., 2014. Chronic disease management: improving
care for people with osteoarthritis. Best Practice & Research Clinical Rheumatology.
Dunphy, L.M., Winland-Brown, J., Porter, B. & Thomas, D., 2015. Primary care: Art and
science of advanced practice nursing. FA Davis.

Dziedzic, K.S., Healey, E.L., Porcheret, M., Ong, B.N., Main, C.J., Jordan, K.P., Lewis, M.,
Edwards, J.J., Jinks, C., Morden, A. & McHugh, G.A., 2014. Implementing the NICE
osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model
osteoarthritis consultation in primary care-the Management of OsteoArthritis In
Consultations (MOSAICS) study protocol. Implementation Science.
Eliopoulos, C., Gerontological nursing. Lippincott Williams & Wilkins.
Gulanick, M. & Myers, J.L., 2016. Nursing Care Plans: Diagnoses, Interventions, and
Outcomes. Elsevier Health Sciences.
LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L. & Reid-Searl, K.,
2015. Medical-surgical nursing. Pearson Higher Education AU.