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Bertha/Bernard Sampson: Clinical Reasoning Pre-Work

Definition & Pathophysiology of the following Disease Processes/Comorbidities (in your own words):

Rheumatoid Arthritis (RA)

RA is an autoimmune chronic inflammatory disorder that affects many joints including those in the hand and feet and with an unknown cause.

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In RA, the body’s immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining (synovial membrane) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint

Osteoarthritis (OA)

It is a degenerative joint disease or “wear and tear” and most common form of arthritis that affects joints in hands, knees, hips, and spine. There is no cure, but the symptoms can be changed.

Osteoarthritis occurs when the cartilage that cushions the end of bones in the joints gradually deteriorates. The cartilage is a firm slippery tissue that enables nearly frictionless joint motion. If the cartilage wears down completely, the bone will rub on bone


Thrombophlebitis is an inflammatory process that causes a blood clot to form and block one or more veins, usually in the legs or arm and causes pain.

The thrombus in the vein causes pain and irritation and may block flow in the veins

Assessment: (what assessment findings would you anticipate seeing with the above listed comorbidities:







(Infectious Disease)




I/O & IV


***For a “Focused Assessment” highlight which three systems would be your priority?***

Based on your patient’s multiple disease processes (comorbidities), integrate all possible findings into the following,
provide your rationale for each answer

Priority Assessment:





Priority Intervention:




Priority Labs and Diagnostics:




Anticipated Priority Orders:




Priority Medications:




Priority Education:




Healthy People 2030 is a national initiative to recognize health disparities of the American population and identify objectives to improve individuals’ overall health and well-being. Some of the goals of Healthy People 2030 include realizing health equity, encouraging healthy behaviors, and preventing disability and death.

Based on your patient’s comorbidities, access Healthy People 2030 at https://health.gov/healthypeople and explore the relevant objectives. Which objective would you choose and how would you implement that objective in the care and health promotion of your patient?


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