Medical-surgical Nursing Demystified

(Sean Pound) #1

(^272) Medical-Surgical Nursing Demystified
TREATMENT
Initial treatment is usually with over-the-counter medications. The patients re-
spond well to these medications. There is no underlying inflammatory disorder, so
the medications can be used on an as-needed basis. Many of the patients are older
and will be on other medications, so it is important that you check for medication
interactions.



  • Administer NSAID (nonsteroidal anti-inflammatory drug)—for any local
    inflammation from irritation at the joint area due to osteophytes or bone spur
    formation:

    • ibuprofen, naproxen

    • diclofenac, diflunisal, etodolac, fenoprofen, flurbiprofen, indomethacin,
      ketoprofen, ketorolac, meloxicam, nabumetone, oxaprozin, piroxicam, sal-
      salate,sulindac, tolmetin



  • Administer acetaminophen for pain relief.

  • Glucosamine and chondroitin sulfate for relief of pain and stiffness.

  • Capsaicin cream topically.

  • Intra-articular injections of corticosteroid up to 3 or 4 times in a year.

  • Intra-articular injections of:

    • hyaluronate sodium; series of 3 to 5 injections

    • hyaluron; series of 3 injections

    • hylan GF 20; series of 3 injections



  • Exercise to maintain joint mobility and muscle tone.

  • Walking aid for stability.


NURSING DIAGNOSES



  • Pain

  • Activity intolerance

  • Impaired mobility


NURSING INTERVENTION



  • Monitor pain to adequately treat pain, as needs may change.

  • Diet modification for weight loss for overweight patients to decrease excess
    stress on weight-bearing joints.

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