4 Osteoarthritis Nursing Care Plans

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Osteoarthritis (OA) also known as degenerative joint disease (DJD) or osteoarthrosis is the most common kind of arthritis associated with progressive degeneration of articular cartilage in synovial joints. Usually, weight-bearing joints and the spine are affected.

Although the disease occurs most often in older adults, osteoarthritis is not part of the normal aging process. Idiopathic (primary) OA is more likely to affect women older than age 65. People with this type of OA have no usually have a family history of the disorder but no direct history of joint disease or injury. Secondary OA occurs more often in men. People with this type of OA are likely to have a previous inflammatory disease and joint injury related to the person’s occupation or sports activity.

Osteoarthritis is characterized by progressive degeneration of the cartilage in a joint. The changes in articular cartilage represent an imbalance between lysosomal enzyme destruction of and chondrocyte production of cartilage matrix. This imbalance leads to an inability of the cartilage to withstand the normal weight-bearing stress in the joint.

Cartilage becomes thin, rough, and uneven, with areas that soften eventually allowing bone ends to come closer together. Micro fragments of the cartilage may float about freely within the joint space, initiating an inflammatory process. True to the progressive nature of the disease, the cartilage continues to degenerate, and bone spurs called osteophytes develop at the margins and at the attachment sites of the tendons and ligaments. Over time these changes have an effect on the mobility and size of the joint. As joint cartilage becomes fissured, synovial fluid leaks out of the subchondral bone and cysts develop on the bone.

Nursing Care Plans

Nursing care plan for clients with osteoarthritis involves relieving pain, promoting comfort measures, maintaining optimal joint function, and preventing progressive disability.

Here are four nursing care plans (NCP) and nursing diagnosis for patients with osteoarthritis:

  1. Acute Pain/Chronic Pain
  2. Impaired Physical Mobility
  3. Activity Intolerance
  4. Risk For Injury
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Activity Intolerance

Nursing Diagnosis

May be related to

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  • Decrease muscle tone
  • Joint pain

Possibly evidenced by

  • Fatigue, Malaise
  • Limitation of movement, muscle atrophy

Desired Outcomes

  • Client will use identified techniques to enhance activity intolerance.
  • Client will report a measurable increase in activity intolerance.
Nursing InterventionsRationale
Assess the physical activity level and mobility of the client.Provides baseline information for formulating nursing goals during goal setting.
Assess the client’s nutritional status.Adequate energy reserves are needed during activity.
Assess the need for ambulation aids (e.g., cane, walker) for ADLs.Assistive devices enhance the mobility of the patient by helping him overcome limitations.
Assist with ADLs while avoiding client dependency.Assisting the patient with ADLs allows conservation of energy. Carefully balance provision of assistance; facilitating progressive endurance will ultimately enhance the patient’s activity tolerance and self-esteem.
Encourage active ROM exercises. Encourage the patient to participate in planning activities that gradually build endurance.Exercise maintains muscle strength, joint ROM, and exercise tolerance. Physical inactive patients need to improve functional capacity through repetitive exercises over a long period of time. Strength training is valuable in enhancing the endurance of many ADLs.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for musculoskeletal disorders and conditions:

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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