Question  Designing a Care Mapp Purpose of Assignment Assist students with the coordination of care for clients with musculoskeletal disorders. Enhance understanding of the nursing process in coordinating care for a client. Course Competency Explain components of multidimensional nursing care for clients with musculoskeletal disorders. Select appropriate nursing interventions when providing multidimensional care to clients experiencing alterations in mobility. Instructions After reviewing the medical conditions presented in the textbook, including osteoporosis, osteomyelitis, disorders of the feet, plantar fasciitis, carpal tunnel disorder, rotator cuff injury, or other musculoskeletal disorders, develop a care map using the template directly after these instructions. For this assignment, include the following: assessment and data collection (including disease process, common labwork/diagnostics, subjective, objective, and health history data), three NANDA-I approved nursing diagnoses, one SMART goal for each nursing diagnosis, and two nursing interventions with rationale for each SMART goal for a client with a musculoskeletal disorder.

 
Designing a Care Map



Assessment 

and

Data Collection
Three NANDA-I Approved                    Nursing Diagnosis
One Smart Goal for EACH Nursing Diagnosis
Two Nursing Interventions with Rationale for EACH Nursing Diagnosis


Disease Process: 

Rheumatoid Arthritis

Common Lab work/Diagnostics:

i.  Erythrocyte sedimentation rate (ESR) test

ii.  Joint ultrasound scan,

iii.  Rheumatoid factor test

iv.  Cyclic Citrullinated Peptide (CCP)

v.  Joint X-Ray

vi.  Joint Magnetic Resonance Imaging (MRI)

vii.  Physical assessment

 

 

 

Assessment Data

Subjective Data

·   Pain on fingers, toes, wrist, and ankle joint,

·   Increased joint stiffness,

·   Feeling of muscle weakness and cramping

 

 

 

 

 

 

 

Objective Data

·  Limited bilateral joint range of motion (ROM),

·  Unsteady gait,

·  Swollen and boggy joints,

·  Contractures and joint deformity

Heath History

·   Female

·   42-years old

·   Has had depressive symptoms,

·   Complains of back and joint pain regularly,

·   Prolonged joint pain,

·   Sometimes feels fatigued.

·   Sometimes needs a cane to walk for longer distances.

·   Grandmother had been diagnosed with RA.

·   Father had been diagnosed with OA.

·   No known allergies.
Nursing Diagnosis: 

Acute pain

Due to related inflammatory processes.

Acute pain is evidenced by prolonged joint pain and reports of fatigue.

 

 

 

 

 

 

 

 

Nursing Diagnosis:

Walking Impairment.

This is evidenced by the reports on muscle weakness, ankle joint pain, fatigue, and the need for a walking cane as an assistive device.

 

 

 

 

 

Nursing Diagnosis

Increased fall risk.

This is evidenced by muscle weakness and limited bilateral ROM.
SMART Goal: 

The patient reports that her pain has reduced in two weeks.

 

 

 

 

 

 

 

 

 

 

 

 

 

SMART Goal:

The patient will report on maintaining unrestricted functional posture while walking, improved muscle strength, and hand and leg function.

 

 

 

 

 

 

 

SMART Goal:

Patient to report decreased to zero falls by the end of the care session and in a period of six (6) months from the end of the session.
1.   Administer the prescribed medications and ensure adherence to the regimen. 

 

Rationale

Medications and adherence to medication can provide faster relief and effectively help manage the pain (Kelly et al., 2020).

2. Gentle massaging of the joints and muscles.

 

Rationale

It can help reduce tension and relax muscles and the joints.

 

1.   Have the patient engage in ROM and resistive exercises.

 

Rationale:

These exercises improve joint and muscle flexibility and strength (Khan et al., 2022).

 

2. The paint must always walk or sit naturally and in the right posture.

 

Rationale:

To help them improve joint ROM and reduce the risk of injury.

 

1. Continuous fall risk assessment.

 

Rationale:

It helps eliminate clutter and other external fall risk factors that increase the chances of falling (Schoberer et al., 2022).

 

2. Physical body exercises

 

Rationale:

Improved muscle strength improves gait control and fall risk(Schoberer et al., 2022).

 

 

 

 

 



References
Kelly, A., Tymms, K., de Wit, M., Bartlett, S. J., Cross, M., Dawson, T., de Vera, M., Evans, V., Gill, M., Hassett, G., Lim, I., Manera, K., Major, G., March, L., O’Neill, S., Scholte-Voshaar, M., Sinnathurai, P., Sumpton, D., Teixeira-Pinto, A., … Tong, A. (2020). Patient and Caregiver Priorities for Medication Adherence in Gout, Osteoporosis, and Rheumatoid Arthritis: Nominal Group Technique. Arthritis Care & Research, 72(10), 1410–1419. https://doi.org/10.1002/ACR.24032

Khan, M. K., Khan, I. A., & Liaquat, A. (2022). Therapeutic Potential of Curcumin with and without Strengthening Exercises in Improving Rheumatoid Arthritis. Journal of the College of Physicians and Surgeons Pakistan, 32(12), 1640–1643. https://doi.org/10.29271/JCPSP.2022.12.1640

Schoberer, D., Breimaier, H. E., Zuschnegg, J., Findling, T., Schaffer, S., & Archan, T. (2022). Fall prevention in hospitals and nursing homes: Clinical practice guideline. Worldviews on Evidence-Based Nursing, 19(2), 86–93. https://doi.org/10.1111/WVN.12571

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