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Gout also known as gouty arthritis is a metabolic disease marked by monosodium urate deposits
that cause red, swollen, and acutely painful joints. Gout can affect any joint but mostly affects
those in the feet, especially the great toe, ankle, and midfoot. Which cause painfully arthritic
joints. It can strike any joint but favors those in the feet and legs. Primary gout usually occurs in
men older than age 30 and in postmenopausal women. Secondary gout occurs in older people.
Gout follows an intermittent course and commonly leaves patients free from symptoms for years
between attacks, serum urate levels rise but produce no symptoms. Gout can lead to chronic
disability or incapacitation and, rarely, severe hypertension and progressive renal disease.
Gout develops in four stages: asymptomatic, acute, intercritical, and chronic:
Acute Stage, first acute attack strikes suddenly and peaks quickly. involves only one or a
few joints.
Chronic polyarticular gout sets in. This final, unremitting stage of the disease (also
known as tophaceous gout) is marked by persistent painful polyarthritis. An increased
concentration of uric acid leads to urate deposits called tophi in cartilage, synovial
membranes, tendons, and soft tissue. Tophi form in the fingers, hands, knees, feet, ulnar
sides of the forearms, pinna of the ear, Achilles tendon and, rarely, in such internal organs
as the kidneys and myocardium. Renal involvement may adversely affect renal function.
Patient history may reveal that the patient has a sedentary lifestyle and a history of
hypertension and renal calculi. He may report waking during the night with pain in his
great toe or another location in the foot. He may complain that initially moderate pain has
grown intense so that eventually he can't bear the weight of bedsheets or the vibrations of
a person walking across the room. He may report accompanying chills and a mild fever.
Inspection typically reveals a swollen, dusky red or purple joint with limited movement.
You may also notice tophi, especially in the outer ears, hands, and feet. Late in the
chronic stage of gout, the skin over the tophi may ulcerate and release a chalky white
exudate or pus. Chronic inflammation and tophaceous deposits prompt secondary joint
degeneration. Erosions, deformity, and disability may develop.
Palpation may reveal warmth over the joint and extreme tenderness. The vital signs
assessment may disclose fever and hypertension. If the patient has a fever, possible occult
infection must be investigated.
Activity intolerance
Acute pain
Anxiety
Nursing Key outcomes Nursing Care Plan For Gout Gouty Arthritis
Nursing key outcome Nursing Care Plan For Gout Gouty Arthritis, patient will:
Activity Therapy: Prescription of and assistance with specific physical, cognitive, social,
and spiritual activities to increase the range, frequency, or duration of an individuals (or
groups) activity
Energy Management: Regulating energy use to treat or prevent fatigue and optimize
function
Simple Relaxation Therapy: Use of techniques to encourage and elicit relaxation for the
purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, or
anxiety
Risk Identification: Analysis of potential risk factors, determination of health risks, and
prioritization of risk reduction strategies for an individual or group