gout

Question 1

most common inflammatory arthritis…..

Answer 1

gout

Question 2

gout

Answer 2

systemic disease caused by a disruption in purine metabolism in which uric acid crystals are deposited in joints and body tissues.

Question 3

gout classified as

Answer 3

primary or secondary.

Question 4

primary gout

Answer 4

• Most common form of gout
• Uric acid production is greater than excretion of it by the kidneys
• Can have a genetic component

Middle aged and older adult males
- Peak onset between ages 40 and 50
- Postmenopausal women are also commonly affected

Question 5

secondary gout

Answer 5

Starts out as another disease or condition
- Usually chronic kidney failure
- Excessive diuretic use
- Causes excessive uric acid in the blood

• Treatment is based on treating the underlying condition
• Any age group is vulnerable

Question 6

risk factors for gout

Answer 6

Obesity
Cardiovascular disease
Trauma
Alcohol ingestion
Starvation dieting
Diuretic use
Some chemotherapy agents
Chronic kidney failure

Question 7

expected findings of gout

Answer 7

Severe joint pain
- Metatarsophalangeal joint of the great toe
- Redness
- Swelling
- Warmth of affected joint

• Painful joints that is more painful when touched or moved
• Appearance of tophi (chronic gout)

Question 8

gout: Erythrocyte sedimentation rate (ESR):

Answer 8

eleavted

Question 9

gout Serum uric acid:

Answer 9

Repeated measurements obtained due to effect of dietary intake on results.
- Consistent elevation above 6.5 mg/dL is associated with gout

Question 10

gout: urinary uric acid

Answer 10

elevated

Question 11

gout: Blood urea nitrogen (BUN), serum creatinine:

Answer 11

elevated

Question 12

meds for acute gout

Answer 12

anti-gout
nsaids
corticosteroids

Question 13

Anti-gout agent

Answer 13

Colchicine: decreases pain and inflammation
- Can cause kidney damage. Use cautiously with patients who have impaired kidney function

Question 14

gout: NSAIDs

Answer 14

Indomethacin or ibuprofen: decreases pain and inflammation
- Can also cause kidney damage.
- Teach patients to take with food

Question 15

gout: corticosteroids

Answer 15

Prednisone: decreases inflammation
- Monitor for fluid retention, hypertension, and renal function
- Teach patients to not stop taking medication abruptly. Doses must be tapered

Question 16

chronic gout: Xanthine oxidase inhibitor

Answer 16

Allopurinol is a maintenance medication to promote uric acid excretion and decrease it’s production. (most common)
- Increase patient’s fluid intake: help flush uric out
- Teach patient to take after meals with water

Question 17

chronic gout: uricosuric

Answer 17

• Promotes uric acid excretion
• Monitor uric acid levels
• Teach patient to not use aspirin because it will decrease the effectiveness of the medication

Question 18

pt. teaching on meds for gout

Answer 18

Teach patient to avoid foods with purine
- Organ meat
- Shellfish

• Teach patient to limit alcohol intake
• Avoid starvation diets (duh!)
• Avoid aspirin and diuretics
• Limit physical and emotional stress
• Increase fluid intake!
• Stress the importance of following medication regime