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Gout

Gout

Category / Primary Body System

  • Musculoskeletal System

Problem

  • Patient is at risk of complications due to gout.

Goal

  • Patient will be free of signs and symptoms of acute gout flare-ups for the next 90 days.

Plan/Approach

  1. Monitoring and Assessment

    • Monitor for signs and symptoms of gout including pain in the great toe (most common), difficulty with weight bearing, and swelling.
  2. Medication Management

    • Administer medications as ordered to manage gout and prevent flare-ups.
  3. Laboratory Tests

    • Check labs as ordered to monitor uric acid levels and kidney function.
  4. Comfort and Positioning

    • Reposition for comfort as needed to alleviate pressure on affected joints.
    • Provide a foot cradle during acute flares to keep bed linens off the foot.
  5. Pain Management

    • Actively intervene for pain during a gout flare and notify the MD if a flare is suspected.
    • Apply cool packs to affected joints as needed for pain relief.
  6. Dietary Management

    • Encourage avoidance of high-purine foods including bullion, broth, gravies, meat extracts, organ meats, shrimp, mackerel, dried legumes, lentils, and baker’s or brewer’s yeast.
  7. Education and Support

    • Provide patient and family with teaching and support regarding gout management and dietary modifications.

Rationale

  1. Monitoring and Assessment

    • Early detection of symptoms allows for prompt intervention and management, reducing the risk of severe complications.
  2. Medication Management

    • Proper administration of medications can help control uric acid levels and prevent gout flare-ups.
  3. Laboratory Tests

    • Monitoring labs helps ensure effective management of gout and early detection of potential issues related to kidney function.
  4. Comfort and Positioning

    • Proper positioning can alleviate pain and prevent further irritation of affected joints.
  5. Pain Management

    • Effective pain management improves patient comfort and facilitates mobility.
  6. Dietary Management

    • Avoiding high-purine foods helps reduce uric acid levels, thereby preventing gout flare-ups.
  7. Education and Support

    • Providing information and support empowers the patient and family to effectively manage gout and adhere to treatment plans.

Actions

  1. Monitoring and Assessment

    • Observe and document signs and symptoms of gout daily, focusing on pain, swelling, and difficulty with weight bearing.
  2. Medication Management

    • Administer prescribed medications on schedule and monitor for effectiveness and side effects.
  3. Laboratory Tests

    • Draw and monitor lab tests as ordered, reporting results to the healthcare team.
  4. Comfort and Positioning

    • Reposition the patient as needed to ensure comfort and reduce joint pressure.
    • Use a foot cradle during acute flares to keep bed linens off the affected foot.
  5. Pain Management

    • Apply cool packs to affected joints as needed for pain relief.
    • Notify the MD immediately if a flare is suspected and manage pain accordingly.
  6. Dietary Management

    • Educate the patient on avoiding high-purine foods and provide dietary guidance to support adherence.
  7. Education and Support

    • Offer teaching sessions for the patient and family on gout management, including lifestyle modifications and medication adherence.
    • Provide written materials and resources for further learning and support.
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