I HUMAN CAMILA BAKER CASE STUDY

I HUMAN CAMILA BAKER CASE STUDY
Problem Statement by Carmen Walton on case Camila Baker
Camila Baker is a 76 yr old female with PMH of HTN, CKD, PUD with GI bleed due to NSAID use. She presents today with
bilateral knee pain. Stated the pain started about 5 years ago, over the past 2 years has gotten progressively worse. Rates the
pain 4-5, with exacerbations up to 7-8 on 0-10 scale. Pain worsens with walking, exercising and stair climbing. She is taking
Tylenol 3000gm daily for pain which is no longer effective, also stated cold weather increases pain. Denies injury and fall.
associated symptoms include swollen and painful finger joints.
Management Plan by Carmen Walton on case Camila Baker
ANA
CBC
ESR
Lt and Rt knee X-ray
Synovial fluid analysis
uric acid, serum
Diclofenac 1% Topical; apply 4 g QID for pain / check creatinine level prior to starting (Hollier, 2021).
Inra-articular corticosteroid injection for exacerbation - limited to 4 times per year are recommended for knee shoulder and hips
and conditionally recommended for hand OA (Hollier, 2021)
Stop taking Tylenol - the use of acetaminophen as a first line agent for OA is no longer recommended due to safety concerns and
lack of efficacy for musculoskeletal pain (Hollier, 2021)
Refer to weight management - weight loss can lead to improvement of symptoms for patients with OA (Hollier, 2021).
Refer to PT for strengthening - - organized program of supervised exercise strongly recommended, to include balance and strength
training, OA is a chronic disorder requiring muscle strengthening to provide joint support (Hollier, 2021).
wear knee braces for stabilizing the joint when exercising. non-pharmacological management for OA per Hollier, 2021.
Apply heat and/or cold as needed for comfort (on 20 min/ off 20 min.) is also a non-pharmacological management intervention
for OA per Hollier, 2021.
Emphasis must be on non-pharmacological treatments to delay use of medications that have adverse effects. Camila has a
history of GI bleed and should not be taking NSAIDS which is the first line pharmacological treatment for OA. Tai chi,
acupuncture and yoga are alternative therapies that may be considered for management of symptoms (Hollier, 2021).