[alire26]

ok so heres my problem I spent over $700 on books this semester. Then when its time for clinicals my books do me no good. I can not seem to find arthritis in my books there are probabley two lines in each book and the one book that has some info does not even help me! does anyone know a website where i can find the Major Nursing Diagnosis for Arthritis????

Thank you

[Valerie Salva]

Just about any careplan book or careplan cards should have it. There are lots of careplan books on Amazon.

[alire26]

i'll try amazon.

thank you

[mama_d]

As a person with arthritis...

Pain, altered mobility, and depression r/t chronic pain issues come to mind.

[Daytonite]

Care plan books, unfortunately, do not hold all the answers as you now know. Care planning is problem solving, something you will be doing as a nurse. The nursing process is designed to help us do that. When care plan books fail--use the nursing process. Here is how it is adapted to care planning:

1. Assessment (collect data from medical record, do a physical assessment of the patient, assess ADL's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   • a physical assessment of the patient
   • assessment of the patient's ability and any assistance they need to accomplish their ADLs (activities of daily living) with the disease
   • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
   • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. This includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. If this information is not known, then you need to research and find it.
     • Use: http://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - Medical Disease Information/Treatment/Procedures/Test Reference Websites
2. Determination of the patient's problem(s)/Nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use). It helps to have a book with nursing diagnosis reference information in it. There are a number of ways to acquire this information.
   • Your instructors might have given it to you.
   • You can purchase it directly from NANDA. NANDA-I Nursing Diagnoses: Definitions & Classification 2007-2008 published by NANDA International. Cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
   • Many authors of care plan and nursing diagnosis books include the NANDA nursing diagnosis information. This information will usually be found immediately below the title of a nursing diagnosis.
   • The NANDA taxonomy and a medical disease cross reference is in the appendix of both Taber's Cyclopedic Medical Dictionary and Mosby's Medical, Nursing, & Allied Health Dictionary
   • There are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:
     • http://www1.us.elsevierhealth.com/Evolve/Ackley/NDH7e/Constructor/
     • http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/index.cfm
3. Planning (write measurable goals/outcomes and nursing interventions)
   • goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. They have the following overall effect on the problem:
     • improve the problem or remedy/cure it
     • stabilize it
     • support its deterioration
   • interventions are of four types
     • Assess/monitor/evaluate/observe (to evaluate the patient's condition)
       • NOTE: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during Step 1.
     • Care/perform/provide/assist (performing actual patient care)
     • Teach/educate/instruct/supervise (educating patient or caregiver)
     • Manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)
4. Implementation (initiate the care plan)
5. Evaluation (determine if goals/outcomes have been met)

Break the medical diagnosis of arthritis down into its symptoms: joint pain, pain after exercise or weight bearing, stiffness in the morning, limited movement, deformities, gait abnormalities, loss of dexterity, muscle spasms, and instability. Complications include contractures, deformities, subluxations, and nerve compressions. Think about how all of this impacts the patient's ability to perform their tasks of daily living and how it has changed their life from what it once was. There are at least 5 possible nursing diagnoses.

[britney_RN]

Just a few that I can think of, of course, you have to apply these to your particular patient and the degree of his/her illness.

1. Impaired physical mobility r/t pain
2. acute pain if came on suddenly, chronic pain if more than 6 months,
3. risk for infection if they take prednisone or some other drug
that lowers their immune system
4. Fear/anxiety r/t long term effects
5. Ineffective coping if the pt seems depressed
6. Fatigue r/t decreased mobility
7. Disturbed sleep pattern r/t pain
8. Self care deficit (depending on the severity)

[CT Pixie]

How about disturbed body image

if the pt is joints are disfigured from the arthritis. It really doesn't matter how hold the pt is, I can't think of anyone who wouldn't be a bit upset about how the joints can be come crooked and misshapen. (my poor grandmother had horribly disfigured hands from years of arthritis and was always trying to hide her hands. I can probably remember seeing her hands maybe a dozen times in the 24 years she was alive when I was.)

[Pat_Pat RN]

How about "Energy field disturbance". I love that one....


"I feel a disturbance in the force..."

[Daytonite]

Originally Posted by Pat_Pat RN

How about "Energy field disturbance". I love that one....


"I feel a disturbance in the force..."

Disturbed Energy Field is used when interventions such as therapeutic touch and acupuncture are being employed.