Balunan, Mikaella C. Obcl 2 BSN 4Y2-1

BALUNAN, MIKAELLA C.
OBCL 2 BSN 4Y2-1
CASE STUDY:
Minda is a 65-year-old female who works as a cutter and dressmaker in a local shop near a university
which sews blazers and uniforms. She has sought consultation in the clinic where you work as a nurse.
She presents with recurrent pain and stiffness in both hands every time she wakes up in the morning
which lasts for about 20 minutes. It happens too, she said, whenever she takes longer periods to rest her
hands from her daily routine in the shop. She wanted to ask too for advice regarding. Ibuprofen or
Glucosamine with Chondroitin to help with what she perceives as “arthritis pain” in both
her hands. She learned about these treatments from a co-worker in the shop. She says she is afraid that
the arthritis “has spread” to her other joints as she is already starting to feel some pains on her right
knee joint too. Her record says she has a BMI of 31 kg/m2, has hypertension and type 2 diabetes
mellitus. Initial examination of both of her hands shows no deformities and no visible signs of
inflammation. When asked, Minda states she is looking for pain relief and fears the arthritis “will
spread” to her other joints as well and eventually render her incapable of work.
Question 1: As gathered from the data, what four risk factors for OA does Minda have? Why do you say
so? (20 points)
 Age- Higher age through oxidative damage, thinning of cartilage, muscle weakening, reduces
the basic cellular mechanism that maintain tissue homeostasis which leads to an insufficient
response to stress or joint injury.
 Gender- the frequency of osteoarthritis in women and men are 68% and 58% respectively,
women have a higher greater level of pain and disability
 Obesity- extra weight can push down on joints causes pain and inflammation, which can make
everyday movement challenging.
 Occupation- facing heavy loads and having stress activities such as workers whose job require
repeated and prolonged sitting are consequently associated hip and hand OA, respectively.
Question 2 Identify at least 4 learning needs that Minda must be given information about?:
 Disease modification
 Diagnosis and management
 Patient knowledge
 Perceived health information needs
What sort of information should be given to her in relation to these needs? (20 points)
 Optimal management of osteoarthritis requires active patient participation. Understanding

perceived heath information needs is important to optimize health service delivery and
outcome in osteoarthritis.
OBCL 2 BSN 4Y2-1
 Health assessment information regarding the diagnosis of osteoarthritis, its impact on daily life
and its logical management options, but also non-pharmacologic option to help them manage
the symptoms. Also, patient wanted this information to be delivered in a clear manner from
multiple sources of health information.
Question 3. Which of the following drug poses the least risk for Minda? Give the rationale for your
answer. Also give the rationale for not choosing the other three (20 points).
Nonsteroidal anti-inflammatory drugs (NSAIDs) treat pain. They also help to prevent painful
inflammation and joint damage. They're the top choice of treatment for OA because they're effective
and nonsedating. NSAIDs come in oral and topical forms.
 Used to treat minor aches and pains of the muscles/joint, works by decreasing a certain natural
substance in body that help pass pain signals to the brain.
 This product may contain inactive ingredients, which can cause allergic reactions or other
problems.
 Used to treat fever and mild to moderate pain.
 Is not an effective choice for relieving osteoarthritis pain in the hip or knee, or for improving
joint function.
 Has been shown to help with osteoarthritis who have mild to moderate pain.
Question 4 (40 points)

Minda also claims of feeling pain and stiffness on her right knee which gives her the feeling that her”
arthritis has spread”. In your mind, you start to evaluate in which of the 4 stages of knee OA her case
belongs to.
• Make a table and fill in with the following descriptions:
Column 1 FOUR STAGES OF OSTEOARTHITIS OF THE KNEE
Column 2 DESCRIPTION of EACH STAGE
Column 3 TREATMENT for EACH STAGE
Column 4 NURSING INTERVENTION
STAGES OF OA DESCRIPTION TREATMENT NURSING

INTERVENTION
During stage 1 is not

DOUBTFUL The joint begins to invasive and focuses on  Lifestyle
narrow, cartilage lifestyle changes, consideration
starting to breakdown supplements, and over- like regular
and the body starts to the-counter exercise may
create osteophytes medications. also prove to
be helpful.
OBCL 2 BSN 4Y2-1
(bone building blocks  Weight loss is

an important
approach to
pain and
disability
improvemen
Taking pain relievers

MILD known as the mild attending physical  Exercise- losing
stage on OA. X-rays therapy sessions to weight through
shows a lot of bone build or maintain diet and
spur growth in the strength and flexibility. exercise can
joint, but the cartilage help relive
is still healthy with no minor
sign of damage. symptoms and
Synovial fluid is still improve quality
present at sufficient of life.
levels for normal joint
movement  low-impact
aerobics and
strength
training can
help
strengthening
the muscle
around the
joint
MODERATE known as moderate known as moderate  Monitor the

osteoarthritis. Cartilage osteoarthritis. Cartilage level of
between bones show between bones show inflammation/
obvious damage and obvious damage and pain the joint
the space between the the space between the
bones begins to bones begins to narrow  Help client to a
narrow. warm
compress.
 Exercise such
as walking
should
moderately
and increase
gradually
Severe OA of the knee,

SEVERE joint space is signific an option id Assistive devices. Canes
ally narrowed with the performing osteotomy and other ambulatory
bones touching each or bone realignment devices care extremely
other. The friction
OBCL 2 BSN 4Y2-1
surgery, wherein the

caused by the bones orthopedic surgeon helpful for ambulation
rubbing against each cuts the bone above
other significantly the knee to shorten the
causes inflammation length and help realign
it for less stress on the
knee joint.

Balunan, Mikaella C. Obcl 2 BSN 4Y2-1

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BALUNAN, MIKAELLA C.

OBCL 2 BSN 4Y2-1

 Diagnosis and management

 Perceived health information needs

 Optimal management of osteoarthritis requires active patient participation. Understanding

 Used to treat fever and mild to moderate pain.

Question 4 (40 points)

Column 1 FOUR STAGES OF OSTEOARTHITIS OF THE KNEE

Column 2 DESCRIPTION of EACH STAGE

Column 3 TREATMENT for EACH STAGE

Column 4 NURSING INTERVENTION

STAGES OF OA DESCRIPTION TREATMENT NURSING

During stage 1 is not

(bone building blocks  Weight loss is

Taking pain relievers

MODERATE known as moderate known as moderate  Monitor the

Severe OA of the knee,

surgery, wherein the

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