Medical-surgical Nursing Demystified

(^270) Medical-Surgical Nursing Demystified

• Administer colchicine during an acute episode to decrease the inflammatory
  response resulting from uric acid deposits. This will help reduce pain.


• Administer NSAID to decrease inflammation to aid in pain relief
  
  
  • indomethacin, ibuprofen, naproxen
  
  
  • Not aspirin; regular dosing causes retention of uric acid.
  
  
  
  


• Administer xanthine oxidase inhibitor medication to reduce total body uric
  acid. Given as long-term treatment to patients with recurrent episodes of gout:
  
  
  • allopurinol
  
  
  
  


• Administer uricosuric medications when the total body amount of urate
  needs to be decreased. Not used in patients who are already excreting a large
  amount of uric acid. Given to patients with chronic gout or recurrent
  episodes:
  
  
  • probenecid, sulfinpyrazone
  
  
  
  


• Low-fat, low-cholesterol diet—elevated uric acid levels accelerate athero-
  sclerosis.


• Immobilize the joint for comfort.

NURSING DIAGNOSES

• Impaired mobility


• Acute pain

NURSING INTERVENTION

• Have the patient drink 3 liters of fluid per day to avoid crystallization of uric
  acid in the kidneys. Increased fluids help flush the uric acid through the
  kidneys.


• Monitor uric acid levels in serum.


• Assist with positioning for comfort.


• Avoid touching inflamed joint unnecessarily. May need to keep clothing or
  bed linen away from area.


• Explain to patient:
  
  
  • Which foods are high-purine proteins—turkey, organ meats, sardines,
    smelts, mackerel, anchovies, herring, bacon.
  
  
  • Avoid alcohol, which inhibits renal excretion of uric acid.