Gout

Sue Renfrow RN, BSN

Gout
*A heterogeneous group of conditions related to a genetic defect
of purine metabolism resulting in hyperuricemia. Check uric acid
levels (know these levels)
Risk Factors
*Hyperuricemia
*Medication
*Diuretics, low-dose aspirin, cyclosporine, nicotinic acid
*Food high in purines (shellfish, organ meats, beer)
*Ethanol use
*Secondary
*Leukemia
*Myeloma
*Anemia
*Psoriasis
Associated Clinical Conditions
*Hypertension
*Chronic kidney disease
*Obesity
*Hyperlipdemia; hypertriglyceridemia
*Insulin resistance, diabetes mellitus
*Cardiovascular disease
Clinical Manifestations
*Acute gouty arthritis subsides in 3-10 by itself
*Intercritical gout (middle phase)
*Chronic tophaceous (little areas that stick out on the side)
Differential Diagnosis
*MSU crystals in synovial fluid
*Fever, leucocytosis & elevated ESR
*X-Rays show soft tissue swelling
Medical Management
*Acute
 *Colchicine (administer at onset of symptoms), NSAIDs, glucocorticoids
*Intercritical- breaks out in between acute and chronic times
*Colchicine, NSAIDs
*Chronic
*Uricosuric agents (allopurinol-lowers blood uric acid levels-worry about
kidneys-kidney stone) KNOW THESE MEDS p.1631
Nursing Management
*Encourage healthy diet
*Weight loss
*Pain management
*Educate (limit alcohol consumption)