Skip to ContentGo to accessibility page
OpenStax Logo
Fundamentals of Nursing

Chapter 22

Fundamentals of NursingChapter 22

Chapter 22

Unfolding Case Study

1.
The nurse would first assess the patient’s respiratory and circulatory systems (based on the ABCs of prioritization). The patient’s vital signs have improved since arriving at the emergency room and she is currently stable. At this point, it is most important for the nurse to recognize the patient is reporting moderate pain in the joints, rated 6/10 on the numerical scale.
2.
The nurse would want to gather more information about the patient’s pain. Using a mnemonic, such as OLDCARTES, the nurse will assess onset, location, duration, characteristics, aggravating factors, radiating, treatment, effect, and severity. The nurse may ask questions such as how long she has had the pain, if the pain is constant or intermittent, if anything makes it better, and if anything makes it worse. After obtaining that information, the nurse will be better prepared to initiate interventions for pain control.
3.
The nurse would hypothesize that the patient’s joint pain negatively impacts her quality of life and probably decreases her level of activity. Even though studies have shown improvement in joint pain from arthritis with increased exercise, patients often find that information to be counterintuitive, instead choosing to rest the joints in an effort to improve symptoms.
4.
The nurse should perform a functional assessment to gain a better understanding of the patient’s ability to perform ADLs. There are several assessments that can be used but it is most likely that the nurse will use the Katz Index of Independence in Activities of Daily Living.
5.
The nurse should first relay these findings to the provider. The provider may order medications to better control her osteoarthritis symptoms or initiate a referral to physical or occupational therapy. Additionally, the nurse should offer support and encouragement to the patient, as losing the ability to perform ADLs can have a significant impact on a patient’s mental health. The nurse should also connect the patient to other resources, such as support groups for individuals with osteoarthritis or access to companies that provide assistive devices.
6.
Findings that would indicate that interventions were effective and optimal outcomes were achieved include improvement in pain level, improved range of motion, and increased ability to perform or assist with ADLs. The patient should also express an understanding of the need for occupational therapy and be an active participant in her plan of care.
PreviousNext
Order a print copy
Citation/Attribution
Reuse and redistribution of this content in digital or print format:
  • This book may not be used in the training of large language models or otherwise be ingested into large language models or generative AI offerings without OpenStax's prior written permission.
  • This book uses the Creative Commons Attribution-NonCommercial-ShareAlike License, which means that you can reuse and modify the material only for noncommercial purposes, must attribute OpenStax, and must distribute any derivative works under the same license.
  • Any commercial printing of this textbook, including using a local or custom printer, must be approved by OpenStax, and proper citation provided.
  • OpenStax-copyrighted images, activities, assessments, and similar components of this book are subject to the same licensing – CC-BY-NC-SA. They can be used for noncommercial purposes with attribution. Commercial use requires permission.
  • Permission requests: Anyone who intends to incorporate this content (including text, images, and other components) into large language models, use it in AI offerings, use it commercially (including in print), and/or has questions about another use case is welcome to complete our reuse request form.
Attribution information
  • If you are redistributing all or part of this book in a noncommercial print format, then you must include on every physical page the following attribution:

    Access for free at https://openstax.org/books/fundamentals-nursing/pages/1-introduction

  • If you are redistributing all or part of this book in a noncommercial digital format, then for every page that includes OpenStax content, you must license the derivative work under the same CC-BY-NC-SA license as the original, and include on every digital page view the following attribution:

    Access for free at https://openstax.org/books/fundamentals-nursing/pages/1-introduction

Citation information

The information below includes the information needed to generate citations in most major styles (APA, MLA, etc.); you must reformat and organize the information as needed to fit the requirements of the style. Use the information below to generate a citation. We recommend using a citation tool such as this one.

© Jul 23, 2026 OpenStax. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo, and Rice University name, and Rice University logo trademarks, or wordmarks are not subject to the Creative Commons license and may not be reproduced without the prior and express written consent of Rice University.