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nursing client with mucoskeletal and autoimmune disorder and gerontology nursing.

nursing client with mucoskeletal and autoimmune disorder and gerontology nursing. GOUT. INTRODUCTION. To better understand gout, it helps to understand the anatomy of the joints. A joint is a union between two bones. Have cartilage. Joint.

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nursing client with mucoskeletal and autoimmune disorder and gerontology nursing.

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  1. nursing client with mucoskeletal and autoimmune disorder and gerontology nursing. GOUT

  2. INTRODUCTION To better understand gout, it helps to understand the anatomy of the joints A joint is a union between two bones. Have cartilage Joint The joint allows the ends of the bones to move against one another. Have a synovial fluid Have a ligaments

  3. WHAT IS GOUT??? Do you have experience of GOUT??? Or anybody at your family have this disease???

  4. DEFINITION It is derived from the Latin word gutta, meaning "a drop" (of liquid). Gout is a metabolic disorder characterized by elevated serum uric acid levels and deposits of urate crystals in synovial fluids and surrounding tissues. Acute Gout also is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation. Chronic

  5. Lifestyle Medical conditions RISK FACTOR Age and Sex Family History

  6. Severe pain at the joint Itchy and peeling skin later Clinical Manifestation Redness and Inflammation Fever Less Flexibility Becomes Nodules

  7. ETIOLOGY Primary Gout (Hereditary) Classification causes of Gout Secondary Gout (internal/external factors, e.g. diet, kidney problems, obesity)

  8. Etiology c0nt. Genetic tendency Overindulgence in alcohol Over weight (Obese) Excessive urine acid in the blood Medication Kidney disease

  9. A high dietary intake of purine, alcohol intake increased purine synthesis, decreased renal excretion Increase uric acid in the blood (hyperuricemia) PATHOPHYSIOLOGY Deposition of uric acid into the joints GOUT

  10. Diagnostic Test Medical History and Physical Examination Test to measure levels of uric acid in blood

  11. Diagnostic Test con’t Test to measure levels of uric acid in urine Extremity X-ray

  12. Diagnostic Test con’t Joint fluid analysis

  13. Medical treatment Colchicine (Colcrys) • Comes in a tablet to take by mouth. • Side effect: Mild nausea, stomach pain and mild diarrhea Allopurinol • Comes as a tablet to take by mouth, take it around the same time every day • Side effect: Upset stomach, diarrhea and drowsiness

  14. Medical Treatment con’t Probenecid • Comes in a tablet to take by mouth.(taken two times a day) • Side effect: Headache, Vomiting, Loss of appetite and Dizziness Corticosteroid (Prednisone) • Comes in a tablet to take by mouth. • Side effect : Fluid retention, Increase BP, Mood Swings

  15. Medical Treatment con’t Febuxostat (Uloric) • Is recommended at 40 mg or 80 mg once daily (tablet) • Side effect: nausea, diarrhea,headache and rash

  16. Surgical Treatment • If gout symptom have occurred off and on without treatment, uric acid crystals may have built up in the joints to form gritty, chalky nodules calledtophi.

  17. Surgical Treatment con’t This tophi can cause infection pain, pressure, and deformed joints. Surgery will recommend by do the excision to remove the tophi

  18. Complication Recurrent gout Advanced gout Joint damage Tophi Kidney damage Kidney stone

  19. NURSING CARE PLAN Nursing Diagnosis: Acute pain related to swelling joints Goal: Pain will be relieved • Nursing Intervention: • The pain should be assessed on an ongoing basis using a scale of one to 10 to describe the severity. • Use cognitive therapy such as creative visualization to distract the patient from his pain. • Apply cold packs to inflamed joints to ease discomfort and reduce swelling. • Encourage the patient to perform techniques that promote rest and relaxation.

  20. NURSING CARE PLAN con’t Nursing Diagnosis: Activity Intolerance related to pain Goal: Patient can do the activity daily living (ADL) • Nursing Intervention: • Evaluate orcontinuously monitor degree of joint inflammation or pain. • Assess the level of intolerance and assist the patient in activities she feels unable to perform. • Assist with activity passive rangeof motion.

  21. NURSING CARE PLAN con’t Nursing Diagnosis: Hyperthermia related to inflammatory process Goal: Client will be maintain normal body temperature without complication • Nursing Intervention: • Monitor vital sign • Provide tepid sponge bath (if not contraindicated) • Promote client safety.

  22. Health Education Avoid or Limit alcohol consumption Do the moderate daily exercise Limit meat and seafood intake Drink at least 6 to 8 glasses of water each day. Avoid fatty foods Take the prescribed medication and follow doctor`s order Eats enough carbohydrate Avoid or Limit alcohol consumption

  23. CONCLUSION As we already know, gout is a monosodium urate, monohydrate crystal deposit disease. In teenagers gout also known as Rich Man’s Disease, because gout can be created by eating an abundance amount of seafood. Clinical pharmacists need to be empowered with knowledge to assist prescribing clinicians in order to maximize therapeutic outcomes when treating gout. To achieve this goal, a foundation of new insights into the pathogenesis of hyperuricemia and gout has been reviewed. Both nonpharmacologic modalities and pharmacologic therapies have been discussed so that greater patient adherence through medication counseling can be achieved.

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