Primary Nursing Diagnosis

Pain (acute) related to fractures and nerve compression

OUTCOMES. Comfort level; Pain control behavior; Pain level; Symptom control behavior; Symptom severity; Well-being

INTERVENTIONS. Pain management; Analgesic administration; Cutaneous stimulation; Heat/cold application; Touch; Exercise therapy; Progressive muscle relaxation


MEDICAL. Generally, patients with Paget's disease who are asymptomatic require no specific treatment but need careful ongoing monitoring. Calcitonin and bisphosphonates are used to treat Paget's disease. Mild pain is usually controlled successfully with nonsteroidal anti-inflammatory drugs. Nonpharmacologic treatment modalities are also prescribed for patients with Paget's

Paget's Disease 687

disease. Heat therapy and massage can help decrease pain. A physical therapy consultation can provide a protocol of simple strengthening and weight-bearing exercises. Braces and other ambulation aids may help support deformities and improve function.

SURGICAL. Surgery may be needed to reduce or prevent pathological fractures, to correct secondary deformities, and to relieve neurological impairment. Unfortunately, joint replacement is difficult because methyl methacrylate (a gluelike bonding material) does not set properly on bone that is affected by Paget's disease.

Pharmacologic Highlights

Medication or

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