A.D. is a 67-year-old male with a

A.D. is a 67-year-old male with a 10 year history of ankylosing spondylitis. He is seen at his doctor’s office for his annual checkup and complains that his Celebrex is not effective. The physician performs a physical examination and finds his overall ROM unchanged from the previous visit, but his neurologic exam demonstrates a changed in his Deep tendon reflexes from 2+ to 1+ since his last visit. A.D. complains of epigastric pain and bloating upon waking in the am. He also reveals that he has difficulty sleeping (insomnia)and at times feels isolated and depressed due his sedentary lifestyle. He denies allergies. Skin intact with good elasticity. The physician probes to discuss any other changes A.D. has made and A.D. states that he is not taking his Celebrex daily but every other day because the medication has become too expensive on his limited income. Nursing Care Assessment: Allergies: Neurologic: Musculoskeletal: Skin: GI: Lab Tests: (research which lab tests can be done when a healthcare provider suspects ankylosing spondylitis) Nursing Diagnosis Implementation: Evaluation: Patient Teaching:

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