N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide • Assist with range of motion when pain is stable; teach isometric exercises for strength • Encourage patient to attend swim class or use a Jacuzzi/whirlpool bath • Refer to medical supply for supportive items: shower bench, walker, crutches, cane, etc. Expected outcomes for osteoarthritis: • Patient able to maintain self-care and mobility with assistive devices • Patient remains free from surgical complications • Demonstrates/verbalizes pain control • Demonstrates proper joint alignment post-op • Verbalizes understanding of disease, management, and self-care techniques Gout Gout is a type of arthritis that comes on suddenly and usually first affects the big toe. It then moves on to intermittent flare-ups of arthritis in the joints. This type of arthritis is caused by uric acid accumulation and the development of nodules (tophi). If someone with gout has a family member with gout then it is possibly genetic. Other factors are obesity, chronic disease, and certain medications. The first attack of gout presents with severe pain in the large toe, or less commonly, other joints. After the acute phase, the pain spreads to the knees, the feet, and the ankle; it also affects the elbows and shoulders. Patients can be severely debilitated during a gout attack. The inflammation subsides and there is a period of relief until the next attack. Elevated uric acid levels can be caused by a diet high in purine, such as organ meats, cured meats, and beer. Gout is treatable, but complications can develop, such as heart and renal disease. Signs and symptoms of gout: • Pain in the joints • Pain and inflammation of the big toe • Sudden pain at night • Tophi nodules • Increased uric acid levels • Renal stones Nursing assessment for gout: • Check joints for redness, inflammation, and swelling • Inquire about patient’s pain level and location of pain • Assess for range of motion to joints • Ask about health history, family history of disease, lifestyle, andmedications • Inquire about patient’s diet; foods high in purine, like organ meats or beer ©2017 Achieve Test Prep Page 116 of 204

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