NURSING CLIENT WITH MUCOSKELETAL AND AUTOIMMUNE DISORDER AND GERONTOLOGY NURSING. GOUT
INTRODUCTIONTo better understand gout, it helps to understand the anatomy of the joints A joint is a union between two Have cartilage bones. Joint The joint allows the ends of the Have a synovial fluid bones to move against one another. Have a ligaments
WHAT IS GOUT??? Do you have experience of GOUT???Or anybody at your family have this disease???
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 Acute that occurs when uric acid builds up in blood and causes joint inflammation. Chronic
Medical Lifestyle conditions RISK FACTORAge and Sex Family History
ETIOLOGY Primary Gout (Hereditary)Classification causes of Gout Secondary Gout (internal/external factors, e.g. diet, kidney problems, obesity)
Etiology c0nt. Genetic tendency Overindulgence in alcohol Over weight (Obese) Excessive urine acid in the blood Medication Kidney disease
A high dietary intake of purine, alcohol intake increased purine synthesis, decreased renal excretion Increase uric acid inPATHOPHYSIOLOGY the blood (hyperuricemia) Deposition of uric acid into the joints GOUT
Diagnostic Test Medical History andPhysical Examination Test to measure levels of uric acid in blood
Diagnostic Test con’tTest to measure levels of uric acid in urine Extremity X-ray
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 thesame time every day• Side effect: Upset stomach, diarrhea and drowsiness
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
Medical Treatment con’t Febuxostat (Uloric) • Is recommended at 40 mg or 80 mg once daily (tablet) • Side effect: nausea, diarrhea, headache and rash
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.
Surgical Treatment con’tThis tophi can cause infection pain, pressure, and deformed joints. Surgery will recommend by do the excision to remove the tophi
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 promote rest and relaxation.
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.
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.
Health Education Avoid or Limit alcohol Do the moderate daily exercise consumption Drink at least 6 to 8 glasses ofLimit meat and seafood intake water each day. Take the prescribed medication Avoid fatty foods and follow doctor`s order Avoid or Limit alcohol Eats enough carbohydrate consumption
CONCLUSIONAs we already know, gout is a monosodium urate, monohydrate crystal depositdisease.In teenagers gout also known as Rich Man’s Disease, because gout can becreated by eating an abundance amount of seafood.Clinical pharmacists need to be empowered with knowledge to assist prescribingclinicians in order to maximize therapeutic outcomes when treating gout.To achieve this goal, a foundation of new insights into the pathogenesis ofhyperuricemia and gout has been reviewed.Both nonpharmacologic modalities and pharmacologic therapies have beendiscussed so that greater patient adherence through medication counseling can beachieved.