An older female adult with osteoarthritis is seen by the nurse. She has a low-grade fever, and she tells the nurse that her pain is changing: it is worse at night and in her shoulder muscles. What should the nurse do to determine if the older adult is now experiencing polymyalgia rheumatica (PMR) rather than an exacerbation of her osteoarthritis?

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Quizplus · Accepted Answer

The change in pain pattern, low-grade fever, and age of the patient make PMR a possibility. PMR often presents with shoulder and hip pain in older adults and can also be accompanied by a low-grade fever and temporal or scalp pain. Assessing joints for swelling and redness may be more characteristic of rheumatoid arthritis. Obtaining blood specimens for blood cultures may be appropriate if there is suspicion of infection but not for diagnosing PMR. Applying moist heat may provide some relief for pain but will not aid in determining if the patient is experiencing PMR.

An Older Female Adult with Osteoarthritis Is Seen by the Nurse