(^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.
- Which foods are high-purine proteins—turkey, organ meats, sardines,