MUSCULOSKELETAL: Gout medications

Question 1

A nurse is providing teaching for a client who has gout and a new prescription for allopurinol. For which of the following adverse effects should the client be taught to monitor?

a. stomatitis
b. insomnia
c. nausea
d. rash
e. increased gout pain

Answer 1

c,d,e
c. nausea
d. rash
e. increased gout pain

Can all be experienced during the first few months of taking allopurinol

Question 2

A nurse is providing teaching for a client who has gout and a prescription for allopurinol. Which of the following statements by the client should indicate to the nurse that the teaching was effective?

a. “I should start taking this medication at 800 mg daily.”
b. “I will have an increased risk of diabetes with this medication.”
c. “I will increase my fluids to at least 2 liters per day.”
d. “I should take this medication twice daily.”

Answer 2

c. “I will increase my fluids to at least 2 liters per day.” - to maintain urine output and prevent renal injury

The initial dosage begins at 100mg daily. Can be increased to manage gout but max will be 800mg/day.

Typically prescribed to be taken once daily.

Question 3

A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications?

a. colchicine
b. allopurinol
c. probenecid
d. pegloticase

Answer 3

a. colchicine

Question 4

A nurse is providing teaching to a client who has gout and urolithiasis.The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? Select all that apply.

a. Take allopurinol as prescribed
b. Exercise several times a week
c. Limit intake of foods high in purine
d. Decrease daily fluid intake
e. Avoid citrus juices

Answer 4

a, b, c
a. Take allopurinol as prescribed
b. Exercise several times a week
c. Limit intake of foods high in purine

Exercise increases mobility which will decrease risk of kidney stones. Purine increases the risk of uric acid stone formation so limiting intake of organ meats, poultry, fish, red wine, and gravy should be informed.

Citrus juices help prevent uric acid production.

Question 5

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?

a. nausea
b. metallic taste
c. fever
d. drowsiness

Answer 5

c. fever - can indicate a potentially fatal hypersensitivity reaction + rash