Drug Order Mechanism of Action Indication Contraindication Adverse Effect Nursing Responsibility

i. Generic Name:  Ibuprofen blocks ibuprofen  Dizziness Nursing Priority: Monitor CBC
Methotrexate temporarily  With NSAID of the patient. Assess for any
the enzyme that  Drowsiness
ii. Brand Name: makes relieves minor hypersensitivity or bleeding.
 Headache
Rheumatrex prostaglandins aches and pains salicylate Before:
hypersensitivity,  Swollen, tender
iii. Classification: (cyclooxygenase) due to gums  Check the expiration date of
Antirheumatic , resulting in headache, as well as in the medicine.
patients who have  Decreased
drug lower levels of backache, the appetite  Give the medicine at the
iv. Route (if prostaglandins. common cold, experienced an
 Reddened eyes right time.
given): Oral As a minor pain of allergic reaction
 Hair loss  Notify the patient what the
v. Dosage: 7.5 mg consequence, arthritis, (urticaria, asthma,
medicine is for.
weekly inflammation, toothache, etc.) after taking
During:
vi. Frequency (if pain and fever are menstrual NSAIDs 
 Make sure that the patient
given): reduced.. cramps, and swallowed the medicine.
muscular aches,  Assess the patient before
and temporarily giving the drug and during
reduces fever. the peak of medication and
after the medication.
After:
 Monitor the patient
especially when side effects
are visible.
 Notify the physician if any
error occurred.
 Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective: Acute pain related to Within 8 hours of 1. Assess patient’s report of 1. Several indicators of After 8 hours of
The patient reports that physical trauma to the providing appropriate pain, noting the characteristics pain perception needs to providing appropriate
she is experiencing joint joint and surrounding nursing intervention of pain. Include the PQRST of be carefully assessed to nursing intervention
pain in her wrist and tissues secondary to the patient will be able pain (P=precipitating factor; help the nurse better was able to:
ankle. She also stated rheumatoid arthritis as to: Q=quality of verbal understand pain and  Reported a
reduction in pain
that her pain and evidenced by joint  Report a reduction description, R= radiation or plan for effective
perception
in pain perception
stiffness is worse in the tenderness and stiffness spread to other parts of the management  Reported that the
 Report that the
pain has completely
morning, but that her pain has body, S= severity and T=time). 2. Heat may help
dissipated
completely
symptoms diminish 2. Take advantage of the use of relieve muscle spasms  Verbalized
dissipated
knowledge of non-
over time.  Verbalize heat and cold therapy applied and joint stiffness,
pharmacologic
knowledge of non-
Objective: to  affected joints. increasing mobility of interventions to
pharmacologic
relieve pain
- mild tenderness at interventions to 3. Administer pain medication, the patient. Cold, on the
relieve pain
both wrists as ordered. other hand, may help
-positive family history 4. Observe the patient’s mood reduce inflammation
of rheumatoid arthritis and demeanor during and swelling.
-mild synovitis in assessment, noting for both 3. Medications help
several proximal verbal and non-verbal cues to block pain perception
interphalangeal (PIP) pain. by the patient, thereby
joints of the hands, 5. Position the patient reducing, if not
including the 2nd PIPs comfortably, or in supine eliminating, its
bilaterally and the right position ensuring that proper presence.
3rd PIP. body alignment is maintained. 4. Non-verbal cues to
6. Provide a firm mattress, or a pain include guarding
bed board and a soft pillow. movement, facial
7. Stress the importance of grimace, dilation of
ensuring that the joints are pupils, increased
placed on a neutral position respirations and others.
and positions of flexion are This helps the nurse
prevented. Use necessary place the pain
equipment when needed. perception of the patient
into context.
5. Some patients in pain
may assume positions
that can worsen the
injury and cause
increased pain.
Ensuring that the
patient maintains
anatomical alignment
prevents contractures
from developing which
may further increase
pain perception and
limit mobility of the
affected joint.
6. Mattresses that are
too soft may place
unnecessary strain on
the affected joints,
increasing pain
perception.
7. Prolonged flexion of
the joints may result in
the formation of
contractures and reduce
overall joint mobility. If
needed, also include in
the instruction proper
use of splints trochanter
rolls, braces and sand
bags.