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Definition
A heterogeneous group of conditions related to a genetic defect of purine
metabolism and fresulting hyperuricemia
Also Known As
Disease Of Kings
Incidence
Primary gout has 85% incidence of all cases, of which 95% are men
Family history of gout. If other members of your family have had gout,
you're more likely to develop the disease.
Age and sex. Gout occurs more often in men than it does in women,
primarily because women tend to have lower uric acid levels than men do.
After menopause, however, women's uric acid levels approach those of
men. Men also are more likely to develop gout earlier — usually between
the ages of 40 and 50 — whereas women generally develop signs and
symptoms after menopause.
Manifestation
4 stages
I. Asymptomatic hyperuricemia
III. A period of time between attacks during which affected joint returns to
normal and client may be asymptomatic for years. Eventually, other
attacks occur
Pathophysiology
In the body, uric acid is made by enzymatic breakdown of tissue and
dietary purines. Huperuricemia develops because of underexcretion or
overproduction of uric acid. In addition to accumulation in the blood, uric
acid is concentrated in the synovial fluid, myocardium, kidneys, and ears.
When uric acid levels reach a certain level, they crystallize, and the
crystals (trophy) are deposited in connective tissue. Because the crystals
are deposited in connective tissue, gout is classified as a form of arthritis.
Diagnostic
Joint fluid test. Your doctor may use a needle to draw fluid from your
affected joint. When examined under the microscope, your joint fluid may
reveal urate crystals.
Blood test. Your doctor may recommend a blood test to measure the uric
acid level in your blood. Blood test results can be misleading, though.
Some people have high uric acid levels, but never experience gout. And
some people have signs and symptoms of gout, but don't have unusual
levels of uric acid in their blood.
Management
Hyperuricemia, trophi, joint destruction, and renal problems are treated
after the acute inflammatory process has subside.
Nursing Diagnosis
Pain related to inflammation, increased disease activity, tissue damage,
fatigue, and lowered tolerance
Nursing responsibilities
Relieving Pain And Discomfort
Reducing Fatigue
Increasing Mobility
Facilitating Self-Care
Improving Sleep
Improving Body Image
Monitoring and Managing Potential Complications
Increasing Knowledge of Disease Management
Promoting Home and Community-Based Care
Health teaching
Illustrations
Reference
Medical Surgical Nursing by Black, 8th ed.
Textbook of Medical Surgical Nursing by Johnson 10th ed.
www.emedicine.com