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NCP Nursing Care Plan For Gout Gouty Arthritis,

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:

asymptomatic ,serum urate levels rise but produce no symptoms

Acute Stage, first acute attack strikes suddenly and peaks quickly. involves only one or a
few joints.

Intercritical, Symptom-free intervals between gout attacks

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.

Causes For Gout Gouty Arthritis

Although the exact cause of primary gout remains unknown, it seems linked to a genetic defect
in purine metabolism, which causes overproduction of uric acid (hyperuricemia), retention of
uric acid, or both.
Nursing Assessment Nursing Care Plan For Gout Gouty Arthritis

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.

Diagnostic tests For Gout Gouty Arthritis

Needle aspiration of synovial fluid
Nursing diagnosis Nursing Care Plan For Gout Gouty Arthritis
Common Nursing diagnosis found in Nursing Care Plan For Gout Gouty Arthritis

Activity intolerance

Acute pain


Deficient knowledge (diagnosis and treatment)

Disturbed sleep pattern

Impaired physical mobility

Risk for injury

Nursing Key outcomes Nursing Care Plan For Gout Gouty Arthritis
Nursing key outcome Nursing Care Plan For Gout Gouty Arthritis, patient will:

Express feelings of comfort and decreased pain

Activities of daily living within the confines of the disease.

Identify strategies to reduce anxiety.

Demonstrate knowledge of the condition and treatment regimen.

Verbalize feeling well rested.

Maintain joint mobility and range of motion.

Express adequate coping skills.

Remain free from complications.

Nursing interventions Nursing Care Plan For Gout Gouty Arthritis

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

Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a

higher level of fitness and health

Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is

acceptable to the patient

Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain

Environmental Management: Comfort: Manipulation of the patients surroundings for

promotion of optimal comfort

Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to

an unidentified source or anticipated danger

Calming Technique: Reducing anxiety in patient experiencing acute distress

Teaching Individual: Planning, implementation, and evaluation of a teaching program

designed to address a patients particular needs

Learning Facilitation: Promoting the ability to process and comprehend information

Learning Readiness Enhancement: Improving the ability and willingness to receive

Sleep Enhancement: Facilitation of regular sleep/wake cycles

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

Environmental Management: Manipulation of the patients surroundings for therapeutic


Exercise Therapy: [specify]: Use of active or passive body movement to maintain or

restore flexibility; use of specific activity or exercise protocols to enhance or restore
controlled body movement.

Pain Management: Alleviation of pain or a reduction in pain to a level of comfort

acceptable to the patient

Traction/Immobilization Care: Management of a patient who has traction and/or a

stabilizing device to immobilize and stabilize a body part

Risk Identification: Analysis of potential risk factors, determination of health risks, and
prioritization of risk reduction strategies for an individual or group

Environmental Management: Safety: Manipulation of the patients surroundings for

therapeutic benefit