It helps to understand clearly about gout for the nursing students

1. Prof. Anandh Sam Perera. S
RN, NSH, Canada
GOUT

2. INTRODUCTION
Joint
A joint is a union between
two bones.
The joint allows the ends
of the bones to move
against one another.
Have
cartilage
Have a synovial
fluid
Have a ligaments

3. DEFINITION
It is derived from the Latin word
gutta, meaning "a drop" (of liquid).
Gout is a metabolic disorder
characterized by elevated serum uric
acid levels and deposits of urate
crystals in synovial fluids and
surrounding tissues.
Gout also is a kind of arthritis
that occurs when uric
acid builds up in blood and
causes joint inflammation.
Acute
Chronic

5. ETIOLOGY
Classification causes
of Gout
Primary Gout
(Hereditary)
Secondary Gout
(internal/external factors,
e.g. diet, kidney
problems, obesity)

6. Etiology cont.
Genetic tendency
Overindulgence in
alcohol
Over weight
(Obese)
Excessive urine
acid in the blood
Medication
Kidney disease

7. RISK
FACTOR
Lifestyle
Medical
conditions
Family History
Age and Sex

8. A high dietary intake
of purine, alcohol
intake
increased purine
synthesis, decreased
renal excretion
Increase uric acid
in the blood
(hyperuricemia)
Deposition ofuric
acid into the joints
PATHOPHYSIOLOGY
GOUT

10. Diagnostic Test
Medical History and
Physical Examination
T
est to measure
levels
of uric acid in blood

11. T
est to measure
levels
of uric acid in urine
Extremity X-ray

12. Diagnostic Testcon’t
Joint fluid analysis

13. Medical treatment
Colchicine
(Colcrys)
•Comes in a tablet to take by mouth.
•Side effect: Mild nausea, stomach pain and mild
diarrhea
Allopurinol
• Comes as a tablet to take by mouth, take it around the
same time every day
• Side effect: Upset stomach, diarrhea and drowsiness

14. Medical Treatment
con’t
Probenecid
•Comes in a tablet to take by mouth.(taken two
times a day)
•Side effect: Headache, Vomiting, Loss of
appetite and Dizziness
Corticosteroid
(Prednisone)
•Comes in a tablet to take by mouth.
•Side effect : Fluid retention, Increase BP,Mood Swings

15. Medical Treatment con’t
Febuxostat
(Uloric)
• Is recommended at 40 mg or 80 mg once daily
(tablet)
• Side effect: nausea, diarrhea, headache and rash

16. Surgical
Treatment
• If gout symptom have occurred off and on without
treatment, uric acid crystals may have built up in the
joints to form gritty, chalky nodules called tophi.

17. Surgical Treatment con’t
This tophi can cause infection pain, pressure, and
deformed joints.
Surgery will recommend by do the excision to remove the
tophi

18. Complication
Recurrent gout Advanced gout
Kidney damage
Joint damage
T
ophi
Kidney stone

19. NURSING CARE PLAN
Nursing Diagnosis: Acute pain related to
swelling joints
Goal: Pain will be relieved
Nursing Intervention:
•The pain should be assessed on an ongoing basis
using a scale of
one to 10 to describe the severity.
•Use cognitive therapy such as creative visualization to
distract the patient from his pain.
•Apply cold packs to inflamed joints to ease discomfort
and reduce
swelling.
•Encourage the patient to perform techniques that

20. NURSING CARE PLAN con’t
Nursing Diagnosis: Activity Intolerance related to pain
Goal: Patient can do the activity daily living (ADL)
Nursing Intervention:
•Evaluate orcontinuously monitor degree of
joint inflammation or pain.
•Assess the level of intolerance and assist the patient
in activities she feels unable to perform.
•Assist with activity passive rangeof motion.

21. NURSING CARE PLAN con’t
• Nursing Diagnosis: Hyperthermia
related to inflammatory process
• Goal: Client will be maintain normal body temperature without
complication
Nursing Intervention:
•Monitor vital sign
•Provide tepid sponge bath (if not
contraindicated)
•Promote client safety.

22. Health Education
Eats enough carbohydrate
Avoid or Limit alcohol
consumption
Limit meat and seafood
intake
Avoid fatty foods
Do the moderate daily
exercise
Drink at least 6 to 8 glasses
Of water each day.
T
ake the prescribed medication
and follow doctor`s order
Avoid or Limit alcohol
consumption

23. ANY QUESTIONS?