Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • 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 • Review laboratory and radiology reports: o X-rays: Joints will show increased inflammation o Synovial fluid: Aspiration of joint fluid will show uric acid crystals o Uric acid levels: Check for elevated uric acid in the urine and blood Nursing diagnosis for gout: • Pain related to joint inflammation • Impaired physical mobility related to joint pain, stiffness, and inflammation • Self-care deficit related to immobility and pain • Knowledge deficit related to disease process, medications, and management

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