Diane is a 50-year-old woman with a past medical history of Type 2 diabetes, Rheumatoid Arthritis, and hypertension. She presents to the Emergency Department due to intractable joint pain over the last 4 hours.

Diane currently works as a Social Worker and was recently transferred to a new job in Child Protective Services. She describes her workdays as long and highly stressful. Diane reports that her health conditions have been well controlled for the past few months. However, she has been experiencing generalized pain and stiffness, swelling of her joints, and unintentional weight loss of 7 lbs over the last two weeks. She also states that her tolerance for activity has drastically decreased, and she is having difficulties completing her activities of daily living independently.

Assessment: The small joints of the hands appear nodular. There is articular joint swelling and warmth in the wrists, hips, and knees bilaterally. There is a mild effusion noted to the right knee. Guarding, rigidity, and facial grimacing was noted during ambulation. Her gait is unsteady and requires moderate assistance. There is decreased range of motion to articular joints. Her grip strength is diminished bilaterally. Vital Signs: BP 138/86, T: 38.1C, P: 104, R: 18, SpO2: 99% RA, Pain: generalized joint pain 7/10. Fasting Capillary glucose: 4.1 mmol/L

1. Identify a priority problem supported by relevant assessment findings.

2. Complete a client-centered Care Plan based on the priority problem using ADPIE (Assessment, Diagnosis, Plan, Intervention, Evaluation).

3. Write a reflective summary that demonstrates your analysis of the situation and how you determined the priority problem. (350-500 words)