Arthritis is a chronic inflammatory condition affecting joints, causing pain, stiffness, and reduced mobility. This nursing diagnosis focuses on managing symptoms, preventing complications, and improving quality of life for patients with arthritis.
Causes (Related to)
Arthritis can develop due to various factors affecting joint health and function:
- Autoimmune response
- Degenerative joint changes
- Age-related wear and tear
- Previous joint injuries
- Genetic factors including:
- Family history
- HLA-B27 gene
- Gender predisposition
- Environmental factors such as:
- Obesity
- Repetitive joint stress
- Occupational hazards
- Smoking
Signs and Symptoms (As evidenced by)
Arthritis presents with characteristic signs and symptoms that nurses must identify for proper diagnosis and treatment.
Subjective: (Patient reports)
- Joint pain and stiffness
- Morning joint stiffness
- Decreased range of motion
- Fatigue
- Sleep disturbances
- Depression or anxiety
- Reduced ability to perform daily activities
Objective: (Nurse assesses)
- Joint swelling and redness
- Decreased joint mobility
- Muscle weakness
- Joint deformities
- Gait changes
- Elevated inflammatory markers
- X-ray changes in joints
- Increased joint temperature
Expected Outcomes
The following outcomes indicate successful management of arthritis:
- The patient will report decreased joint pain
- The patient will demonstrate improved joint mobility
- The patient will maintain independence in ADLs
- The patient will use prescribed medications correctly
- The patient will implement joint protection techniques
- The patient will maintain a healthy weight
- The patient will demonstrate proper use of assistive devices
Nursing Assessment
Pain Assessment
- Evaluate pain intensity and characteristics
- Document pain patterns
- Assess the impact on daily activities
- Note aggravating and relieving factors
- Monitor response to interventions
Joint Assessment
- Evaluate the range of motion
- Check for swelling and inflammation
- Monitor joint stability
- Document deformities
- Assess muscle strength
Functional Assessment
- Evaluate ADL independence
- Assess mobility status
- Check the use of assistive devices
- Document activity limitations
- Monitor fatigue levels
Psychological Assessment
- Evaluate coping mechanisms
- Assess mood and anxiety
- Monitor sleep patterns
- Check social support
- Document impact on quality of life
Medication Management
- Review medication compliance
- Monitor for side effects
- Assess pain management effectiveness
- Document alternative therapies
- Check for drug interactions
Nursing Care Plans
Nursing Care Plan 1: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to joint inflammation and tissue damage as evidenced by reported pain intensity of 7/10 and limited joint mobility.
Related Factors:
- Joint inflammation
- Tissue damage
- Morning stiffness
- Activity limitations
Nursing Interventions and Rationales:
- Administer prescribed medications as scheduled
Rationale: Ensures consistent pain management - Teach non-pharmacological pain management techniques
Rationale: Provides additional pain relief methods - Monitor pain levels and response to interventions
Rationale: Allows for treatment adjustment as needed
Desired Outcomes:
- The patient will report decreased pain levels
- The patient will demonstrate effective use of pain management strategies
- The patient will maintain optimal activity levels
Nursing Care Plan 2: Impaired Physical Mobility
Nursing Diagnosis Statement:
Impaired Physical Mobility related to joint stiffness and pain as evidenced by difficulty performing ADLs and decreased range of motion.
Related Factors:
- Joint pain and stiffness
- Muscle weakness
- Fear of movement
- Joint deformities
Nursing Interventions and Rationales:
- Assist with ROM exercises
Rationale: Maintains joint mobility and prevents contractures - Teach proper use of assistive devices
Rationale: Promotes safe mobility and independence - Implement energy conservation techniques
Rationale: Reduces fatigue and maintains activity tolerance
Desired Outcomes:
- The patient will demonstrate improved joint mobility
- The patient will perform ADLs independently
- The patient will use assistive devices correctly
Nursing Care Plan 3: Self-Care Deficit
Nursing Diagnosis Statement:
Self-Care Deficit related to joint pain and limited mobility as evidenced by difficulty completing personal hygiene tasks.
Related Factors:
- Joint pain
- Limited range of motion
- Fatigue
- Decreased strength
Nursing Interventions and Rationales:
- Provide adaptive equipment
Rationale: Facilitates independence in self-care - Teach energy conservation techniques
Rationale: Maximizes ability to complete tasks - Assist with ADLs as needed
Rationale: Ensures basic care needs are met
Desired Outcomes:
- The patient will maintain optimal independence in self-care
- The patient will use adaptive equipment effectively
- The patient will demonstrate improved self-care abilities
Nursing Care Plan 4: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to arthritis management as evidenced by incorrect medication use and poor understanding of joint protection principles.
Related Factors:
- Complex treatment regimen
- Limited health literacy
- Lack of exposure to information
- Misconceptions about Arthritis
Nursing Interventions and Rationales:
- Provide education about the disease process
Rationale: Improves understanding and compliance - Demonstrate joint protection techniques
Rationale: Prevents further joint damage - Review medication management
Rationale: Ensures proper treatment implementation
Desired Outcomes:
- The patient will demonstrate an understanding of arthritis management
- The patient will correctly use the prescribed medications
- The patient will implement joint protection techniques
Nursing Care Plan 5: Risk for Falls
Nursing Diagnosis Statement:
Risk for Falls related to impaired mobility and joint instability as evidenced by unsteady gait and history of near-falls.
Related Factors:
- Joint instability
- Muscle weakness
- Balance impairment
- Environmental hazards
Nursing Interventions and Rationales:
- Conduct an environmental safety assessment
Rationale: Identifies and reduces fall risks - Implement fall prevention strategies
Rationale: Reduces risk of injury - Teach safe transfer techniques
Rationale: Promotes proper body mechanics
Desired Outcomes:
- The patient will remain free from falls
- The patient will demonstrate safe mobility techniques
- The patient will maintain a safe environment
References
- Bech B, Primdahl J, van Tubergen A, Voshaar M, Zangi HA, Barbosa L, Boström C, Boteva B, Carubbi F, Fayet F, Ferreira RJO, Hoeper K, Kocher A, Kukkurainen ML, Lion V, Minnock P, Moretti A, Ndosi M, Pavic Nikolic M, Schirmer M, Smucrova H, de la Torre-Aboki J, Waite-Jones J, van Eijk-Hustings Y. 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis. 2020 Jan;79(1):61-68. doi: 10.1136/annrheumdis-2019-215458. Epub 2019 Jul 12. PMID: 31300458.
- Brent LH. Inflammatory arthritis: an overview for primary care physicians. Postgrad Med. 2009 Mar;121(2):148-62. doi: 10.3810/pgm.2009.03.1987. PMID: 19332973.
- Lesko M, Young M, Higham R. Managing inflammatory arthritides: Role of the nurse practitioner and physician assistant. J Am Acad Nurse Pract. 2010 Jul;22(7):382-92. doi: 10.1111/j.1745-7599.2010.00525.x. PMID: 20590962.
- Finckh A. Early inflammatory arthritis versus rheumatoid arthritis. Curr Opin Rheumatol. 2009 Mar;21(2):118-23. doi: 10.1097/BOR.0b013e3283235ac4. PMID: 19339921.
- Vivienne, L., Michael, S. Nurses’ roles in the management of chronic inflammatory arthritis: a systematic review. Rheumatol Int 38, 2027–2036 (2018). https://doi.org/10.1007/s00296-018-4135-9
