Medical-surgical Nursing Demystified

(Sean Pound) #1

(^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.



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