IMMUNODISORDERS

1. GOUT

2. INTRODUCTION
To better understand gout, it helps to
understand the anatomy of the joints
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. WHAT IS GOUT???
Do you have experience of GOUT???
Or anybody at your family have this disease???

4. 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.

5. Gout also is a kind of arthritis that occurs
when uric acid builds up in blood and causes
joint inflammation.

6. Classification
Acute
Chronic

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

8. • Hereditary
Primary
Gout
• Internal/External
factors,
• e.g. diet, kidney
problems, obesity)
Secondary
Gout
Classification: Causes of Gout
ETIOLOGY

9. Genetic
tendency
Overindulgence
in alcohol
Over weight
(Obese)
Excessive uric
acid in the
blood
Medication Kidney disease
ETIOLOGY Cont..

10. 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
GOUT
PATHOPHYSIOLOGY

11. Clinical features

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

13. Diagnostic Test cont…
Test to measure
levels of uric acid in
urine
Extremity
X-ray

14. Diagnostic Test cont……..
Joint fluid
analysis

15. MANGEMENT

16. Colchicine
(Colcrys)
•Comes in a tablet to take by
mouth.
•Side effects: 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 effects: Upset stomach,
diarrhea and drowsiness
Medical management

17. 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 management

18. Febuxostat
(Uloric)
•Is recommended at 40 mg or 80 mg once
daily
•Side effect: nausea, diarrhea, headache
and rash
Medical management

19. 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.

20. Surgical Treatment
Tophi can cause infection pain,
pressure, and deformed joints. Surgery will
recommend by do the excision to remove the
tophi

21. Complication
Recurrent
gout
Advanced
gout
Kidney
damage
Joint
damage
Tophi
Kidney
stone

22. Nursing management

23. NURSING CARE PLAN
• Assessment
• History collection

24. • Physical examination

25. Nursing diagnosis
1. Acute pain related to swelling joints
2. Activity Intolerance related to pain
3. Hyperthermia related to inflammatory process

26. 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

27. Activity Intolerance related to pain
• Goal: Patient can do the activity daily living
• Nursing Intervention:
• Evaluate or continuously 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 range of motion

28. 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.

29. 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.
Take the prescribed medication
and follow doctor`s order
Avoid or Limit alcohol
consumption