Reference no: EM133602594

Assignment:

1. Mrs. J is a 65 year old Caucasian woman who has not been seen in the clinic for 2 years because of a change in insurance. She recently retired from a grocery store where she is a cashier. She comes to your clinic today for joint discomfort, which has increased over the last four years. She is concerned she may have tumors.

Subjective Data:

• Stiffness and aching in hands, right hip and left knee
• Stiffness is present in the morning but improves after a warm shower
• Walking, standing, and gardening for long periods of time cause increased pain in her hip and knee
• One year ago she noticed bumps on her fingers.
• Social: loves to garden and square dance, is married

Objective Data:

• Bilateral joint tenderness of the DIP, and PIP joints of the 2nd and 3rd digits with no swelling
• 2 mm Heberden's nodules on the DIP of both 4th and 3rd digits
• Discomfort on flexion of the right hip noted during exam
• Using Tylenol without relief

A. How might the nurse explain the pathophysiology of osteoarthritis to Mr. J.?

B. What manifestations does Mrs. J. have that suggest the diagnosis of osteoarthritis?

C. How is osteoarthritis diagnosed?

D. Tylenol is not helping Mrs. J's pain. What other medications or 'over the counter' medications might be prescribed for this patient and why?

E. What other suggestions may be offered to Mrs. J concerning management of her disease and preserving joint function and mobility?

F. What alternatives of treatment are available if conservative treatment fails? Name at least 2.

G. Mrs. J is distressed when she finds out she has osteoarthritis. She states she just can't imagine living without being able to garden and square dance. How might you respond to her statement?

H. Based on the assessment data presented, write one or more appropriate nursing diagnoses.