Medical Surgical Nursing

(Tina Sui) #1

The use of braces, splints, and assistive devices for ambulation, such as canes, crutches,
and walkers, eases pain by limiting movement or stress from weight bearing on painful
joints. Acutely inflamed joints can be rested by applying splints to limit motion. Splints
also support the joint to relieve spasm. Canes and crutches can relieve stress from
inflamed and painful weight-bearing joints while promoting safe ambulation. Cervical
collars may be used to support the weight of the head and limit cervical motion. A
metatarsal bar or special pads may be put into the patient's shoes if foot pain or
deformity is present (Egan, Brosseau, Farmer, et al., 2006).
Other strategies for decreasing pain include muscle relaxation techniques, imagery,
self-hypnosis, and distraction.


Decreasing Fatigue
Fatigue related to rheumatic disease can be both acute (brief and relieved by rest or
sleep) and chronic. Chronic fatigue, related to the disease process, is persistent,
cumulative, and not eliminated by rest but is influenced by biologic, psychological,
social, and personal factors.


Plan of Nursing Care: Care of the Patient With a Rheumatic Disease

Nursing Diagnosis: Acute and chronic pain related to inflammation and increased
disease activity, tissue damage, fatigue, or lowered tolerance level
Goal: Improvement in comfort level; incorporation of pain management techniques
into daily life.
NURSING
INTERVENTIONS


RATIONALE EXPECTED


OUTCOMES



  1. Provide variety of
    comfort measures


 Application of heat
or cold
 Massage, position
changes, rest
 Foam mattress,
supportive pillow,
splints
 Relaxation
techniques,
diversional activities


  1. Pain may respond to
    non-pharmacologic
    interventions such as joint
    protection, exercise,
    relaxation, and thermal
    modalities.


 Identifies factors
that exacerbate or
influence pain
response
 Identifies and uses
pain management
strategies
 Verbalizes decrease
in pain
 Reports signs and
symptoms of side
effects in timely
manner to prevent
additional problems
 Verbalizes that pain
is characteristic of
rheumatic disease
 Establishes realistic
pain-relief goals
 Verbalizes that pain
often leads to the
use of nontraditional
and unproven self-
treatment methods
 Identifies changes in
quality or intensity


  1. Administer anti-
    inflammatory, analgesic,
    and slow-acting
    antirheumatic medications
    as prescribed.
    2. Pain of rheumatic
    disease responds to
    individual or combination
    medication regimens.

  2. Individualize medication
    schedule to meet patient's
    need for pain management.
    3. Previous pain
    experiences and
    management strategies
    may be different from
    those needed for
    persistent pain.

  3. Encourage verbalization
    of feelings about pain and
    4. Verbalization promotes
    coping.

Free download pdf