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NANDA NURSING

Thursday, June 16, 2011

Nursing Diagnosis and Nursing Intervention for Rheumatoid Arthritis

Nursing Diagnosis and Nursing Intervention for Rheumatoid Arthritis

Nursing Diagnosis and Nursing Intervention for Rheumatoid Arthritis

Nursing Diagnosis

Pain (Acute / Chronic)

Related to:
  • Tissue distension by fluid accumulation / inflammation
  • Joint destruction.

Can be evidenced by :
  • Complaints of pain, discomfort, fatigue.

  • Self-focusing / narrowing of focus
  • Behavior distraction / autonomic response
  • Behavior that is carefully / protect

Expected Result / criteria for evaluation of patients will :
  • Showed pain relief / control
  • Looks relaxed, sleep / rest and participate in activities according to ability.
  • Follow the program prescribed pharmacological
  • Combining the skills of relaxation and entertainment activities into a program of pain control.

Nursing Interventions and Rational for Rheumatoid Arthritis :
  1. Assess complaints of pain, note the location and intensity (scale 0-10). Note factors that accelerate and signs of pain non-verbal.
    Rational: To assist in determining the need for pain management and program effectiveness.

  2. Give a hard mattress, small pillows, bed linen Elevate as needed.
    Rational: A soft mattress, large pillows, will prevent the maintenance of proper body alignment, placing stress on joints that hurt. Elevation of bed linen lowering the pressure in the inflamed joints / pain.

  3. Place / monitor the use of pillows, sandbags, splint, brace.
    Rational: Resting sore joints and maintain a neutral position. Use of the brace can reduce pain and can reduce damage to the joints.

  4. Suggest to frequently change positions, Help to move in bed, prop a pain in the joints above and below, avoid jerky movements.
    Rationale: Prevent the occurrence of general fatigue and joint stiffness. Stabilize the joint, reducing the movement / pain in the joints.

  5. Instruct the patient to a warm bath or shower at the time awake and / or at bedtime. Provide a warm washcloth to compress the joints are sick several times a day. Monitor water temperature, water bath, and so on.
    Rational: Heat increases muscle relaxation, and mobility, reduce pain and release the stiffness in the morning. Sensitivity to heat can be removed and dermal wound can be healed.

  6. Give a massage.
    Rationale: Increase relaxation / pain relief.

  7. Encourage the use of stress management techniques, such as progressive relaxation, therapeutic touch, biofeed back, visualization, imagination guidelines, self hypnosis, and breath control.
    Rationale: Increase relaxation, giving a sense of control and possibly enhance the coping abilities.

  8. Engage in activities of entertainment that is appropriate for individual situations.
    Rational: To focus attention again, provide stimulation, and increased self-confidence and feeling healthy.

  9. Give the drug prior to activity / exercise that is planned as directed.
    Rationale: Increase relaxation, reduce muscle tension / spasm, making it easier to participate in therapy.

  10. Collaboration: Give medicines as directed.
    Rational: As an anti-inflammatory and mild analgesic effect in reducing stiffness and improving mobility.

  11. Give ice-cold compress if needed
    Rational: The cold can relieve pain and swelling during the acute period.

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