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
- Provide variety of
comfort measures
Application of heat
or cold
Massage, position
changes, rest
Foam mattress,
supportive pillow,
splints
Relaxation
techniques,
diversional activities
- 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
- Administer anti-
inflammatory, analgesic,
and slow-acting
antirheumatic medications
as prescribed.
2. Pain of rheumatic
disease responds to
individual or combination
medication regimens. - 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. - Encourage verbalization
of feelings about pain and
4. Verbalization promotes
coping.