Gout

A common joint affected by gout is the joint at the base of the big toe. Gout is characterized by sudden, intense bouts of pain, redness, and tenderness in joints.

Anyone might be afflicted by gout, a complicated form of arthritis. Gout is more common in men, although it also affects women more frequently after menopause.

Nursing Management

• Give painkillers if necessary, especially during severe bouts.
• Use cold packs on swollen, inflammatory joints to relieve pain and suffering.
• administering additional medications and anti-inflammatory meds as directed.
• Administer painkillers at times that allow for the most rest to encourage sleep.
• Encourage bed rest, but keep bed sheets off delicate, swollen joints by using a bed cradle.
• Encourage the patient to practice relaxation and sleep-promoting exercises.
• Offer a wholesome diet. Avoid foods high in purine.
• As much self-care both before and after surgery as his pain and immobility permit.
• Request that the patient drink a lot of water to avoid renal calculi.
• With an obese patient, discuss the principles of gradual weight loss.
• Encourage the patient to take care of himself as much as his pain and immobility will allow.
• Offer emotional support throughout diagnostic procedures and tests.

Gout

A common joint affected by gout is the joint at the base of the big toe. Gout is characterized by sudden, intense bouts of pain, redness, and tenderness in joints.

Anyone might be afflicted by gout, a complicated form of arthritis. Gout is more common in men, but it also affects women more frequently after menopause.

Gout attacks can come on suddenly, frequently causing you to wake up in the middle of the night feeling as though your big toe is on fire. Even the weight of the sheet may seem intolerable on the affected joint, which is hot, swollen, and extremely tender.

Pathophysiology

The body produces uric acid, which is naturally present in the bloodstream and is formed during the breakdown of waste products, primarily those containing purine, a chemical that is also present in high concentrations in some foods, such as brains, liver, dried peas, and beans, as well as in the body itself.

Normally, uric acid is removed from the blood by the kidneys and excreted in the urine. However, occasionally the kidneys are unable to remove enough uric acid from the blood or the body creates too much uric acid. Hyperuricemia is a condition that results from an accumulation of it in the blood stream.

Sign and symptoms

• Hyperuricemia: Increased amount of uric acid in the blood.
• The presence of uric acid crystals in joint fluid: These crystals are caused by high concentrations of uric acid.
• Arthritis producing a swollen, red and warm joint.
• Attacks of arthritis in only one joint, usually the toe, ankle, knee.
• Fever: Some patients have an elevated temperature.
• Less flexibility: The affected joint may be harder to use the patient has limited movements.

Diagnosis

• Physical examination and medical history: A person description of symptoms and other information.
• Blood investigation: A test that measures the level of uric acid in the blood.
• Test of synovial fluid: The most definitive way to diagnose gout is to take a sample of fluid from the joint and test it for urate crystals.

Treatments

Gout is usually treated with medicines, these include:

• NSAIDs (nonsteroidal anti-inflammatory drugs): These help combat inflammation and pain. Ibuprofen and naproxen are NSAIDs. There is an increased risk of stomach pain, ulcers and bleeding in some patients who take this drugs the higher the dosage the higher the risk.
• Colchicine: An effective drug for gout. However, a number of patients might experience diarrhea, vomiting, and nausea. It is often given to patients who are unable to take NSAIDs.
• Steroids: These may help combat inflammation and relieve pain. The patient may receive the medication orally or it could be injected right into the joint.

Nursing Management

• Give pain medication as a need especially during acute attacks.
• Apply cold packs to inflamed joints to ease discomfort and reduce swelling.
• Administer anti-inflammatory medication and other drugs, as ordered.
• To promote sleep, administer pain medication at times that allow maximum rest.
• Encourage bed rest, but use a bed cradle to keep bed linens off sensitive, in inflamed joints.
• Encourage the patient to perform techniques that promotes rest and relaxation.
• Provide nutritious diet. Avoid purine rich foods.
• Before and after surgery as much self-care as his immobility and pain allow.
• Urge the patient to drink plenty of fluids to prevent renal calculi.
• Discuss the principles of gradual weight reduction with an obese patient.
• Urge the patient to perform as much self-care as his immobility and pain allow.
• Provide emotional support during diagnostic test and procedures.