Gout (Gouty Arthritis)

A form of arthritis characterized by severe burning pain, redness, tenderness and stiffness in joints. Gout is a kind of arthritis caused by uric acid crystals forming in one or more joints.

Symptoms

  • Usually start at night
  • Very common in the big toe joint but can also occur in other joints
  • Affected joint becomes red, feels hot, and painful.
  • Pain increases when the joint is touched.

Causes & Risk Factors

  • Foods that are rich in purines increase the risk for gout – Salmon, sardines, organ meats, asparagus, mushrooms and herring are examples of foods rich in purines.
  • Gout is hereditary.
  • Overweight, Alcohol, High cholesterol, Diabetes, high blood pressure
  • Men develop gout more often than women.

Treatment

  • Rest
  • Pain relievers & anti-inflammatory medications – Motrin, Advil and Naproxen

Patient teaching – Teach patient to

  • Take all medication as prescribed.
  • Inform the MD before taking any aspirin product because aspirin can interfere with other medications
  • Lose weight if patient is overweight.
  • Seek treatment promptly for high blood pressure, high cholesterol or diabetes
  • Follow diet prescribed – low-salt, & low-fat diet.
  • To avoid alcohol and foods that are high in purines.
  • To drink lots of water to help flush uric acid from the body.

Complications

  • When gout is not treated, a gout attack can last for days or even weeks.
  • Prolong attacks for many years may lead to TOPHI – uric acid crystals that form lumps under the skin.
    • Tophi usually form on the toes, fingers, hands and elbows.
  • Gout may also lead to kidney disease or kidney stones from uric acid crystals that collect in the urinary tract.

Reference: Lewis & Heitkemper, Med-Surg Nursing 2007

Rophem Nursing 🙂

Systemic Lupus Erythematosus (SLE)

What is SLE?

  • SLE is an autoimmune disease that can affect many parts of the body, like the kidneys, skin, the heart, joints, and lungs.
  • Systemic lupus erythematosus (SLE) is the most common and most serious type of lupus.
  • Discoid lupus erythematosus (DLE) also called cutaneous lupus erythematosus. DLE affects the skin. It does not affect other organs.
  • DLE shows up like a red rash or scaly patch, commonly found on the face or scalp, butterfly rash.
  • Leading cause of death in clients with Lupus – Kidney and Cardiac involvement.
  • Another type of lupus is the Drug-induced lupus, this type is caused by reaction to some prescription drugs.

Triggers of Lupus

  • Sunlight – very specific with Lupus
  • Stress
  • Pregnancy
  • Drugs

Assessment Findings – SLE

  • Joint pain and decreased mobility, Photosensitivity, HTN,
  • Fever, Pericarditis, Nephritis, Pleural effusion

Instructions for the client with SLE

  • Instruct client to avoid prolonged exposure to sunlight.
  • Avoid stress and illness
  • Provide instruction about medications – steroids.

Nursing Care

  • Monitor for Pain, mobility, and fatigue,
  • Vital signs
  • UOP, BUN, & serum creatinine.

Medications

  • Corticosteroids
  • NSAIDs (not for clients who have renal compromise)
  • Immunosuppressant agents
  • Antimalarial

Complications – Lupus nephritis, Pericarditis and myocarditis

References:
Medical-Surgical Nursing, 9th Edition by Lewis, Heitkemper, et all.
Understanding Medical Surgical Nursing by Paula D Hopper

Rophem Nursing. 

 

Never Give Up

When there is a will, there is a way!!
You truly want to do something; and there are obstacles, you will always find a way to do it.

Set your eyes on the prize; always remember that nothing comes easy in life. If it were to be easy then everyone will have it and it wouldn’t worth that much.
What is the goal that you want to achieve at this time; stay focused, have the strong will and gently find available resources.

Other things will happen at the same time, life has to go on and these things may appear to stand in your way. Try not to pay too much attention to distractions. Stay focused. A person does not fail until they give up. Never give up!!!

With Love
Rophem 🙂