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:
Activity Intolerance
Nursing Diagnosis
May be related to
- 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 Interventions | Rationale |
---|---|
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. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023Â (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for musculoskeletal disorders and conditions:
- Amputation | 4 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Fracture | 11 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Laminectomy (Disc Surgery) | 8 Care Plans
- Osteoarthritis | 4 Care Plans
- Osteoporosis | 4 Care Plans
- Rheumatoid Arthritis | 6 Care Plans
- Scoliosis | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans
- Total Joint (Knee, Hip) Replacement | 5 Care Plans
Hi, this was very educational!