Gout

Question 1

What is Gout?

Answer 1

Systemic arthritis resulting from deposition of urate crystals in tissues & fluids within the body –> Inflammation
-Nephrophilic

Question 2

What are the two types of Gout?
Which one is more common?
What gender is gout more commonly associated with?

Answer 2

1. Primary gout –> MORE COMMON
2. Secondary gout

More common in MEN (suckerrrrrs)

Question 3

What is Primary Gout? Onset?

Answer 3

Due to one of several inborn errors of purine metabolism
Production of uric acid > excretion of uric acid
May be inherited
Peak onset is from 40-50

Question 4

What is Secondary Gout? Onset?

Answer 4

Hyperuricemia from secondary disease or problem

Onset at ANY age

Question 5

What are the 3 Stages of Gout?

Answer 5

1. Asymptomatic hyperuricemia
2. Acute gouty arthritis
3. Chronic/Tophaceous Gout

Question 6

How do we know Gout is present during Stage I if it’s Asymptomatic?

Answer 6

Only obvious from a serum uric acid level

Question 7

Gout Stage II is characterized by:

What extremity is most commonly affected?

Answer 7

Excruciating pain and inflammation; “ATTACK!”

Da BIG Toe

Question 8

Gout Stage III only occurs after _______.

What’s happening during this stage?

Answer 8

Repeated acute gout attacks

Urate crystals are deposited under the skin and in major organs; can result in kidney stones

Question 9

Assessment + Gout
Signs and Symptoms:
What joints are typically affected?

Answer 9

Gather Hx regarding S/S previously occurring

1. Joint inflammation
   
   • Typically affects smaller joints
2. Severe pain
3. Renal insufficiency due to Kidney stones
4. Tophi

Question 10

What’s up with Tophi?

Where might you see them? (3)

Answer 10

Caused by repeated, unmanaged gout attacks

1. Outer ear
2. Arms
3. Fingers

Question 11

Interventions + Gout

Is gout easy or hard to manage?

Answer 11

EASY PEASY with drugs

but need to take them after a meal

Question 12

Interventions + Gout

What education should we provide related to dietary changes?

Answer 12

1. INCREASE FLUIDS
2. Low purine diet
   - no organ meat, shellfish, or oily fish with bones
3. Increase Alkaline ash (?) foods
   - citrus foods/juice, milk/dairy products
4. NO ALCOHOL!!!

Question 13

Interventions + Gout

What drugs should be avoided?

Answer 13

1. ASPIRIN

2. Diuretics

Question 14

Interventions + Gout

What’s another big intervention we should address related to gout?

Answer 14

STRESS MANAGEMENT!

-teach pt on ways to avoid stress

Question 15

During an acute gout attack, what are our priorities?

Answer 15

DON’T TOUCH THE AFFECTED EXTREMITY

-Can use a bed cradle

Question 16

What do we need to know about Gout for the exam?

Answer 16

Who gets it
How it presents
That it is easily managed/treated (medications, etc.)