Gout Presented by Imran khan

BSc nursing year II semester IV

Khyber medical University Peshawar

objectives• At the end of my presentation the student

will be able to:• Define Gout disease.• Enlist the signs and symptoms.• Discus the causes of the disease.• Enlist the risk factors of the disease• discus the pathophysiology of the disease.

objectives• Enlist the complication of the disease.• diagnose the disease.• Describe the management of the disease.• Discus the epidemiology of the disease.• Formulate the nursing diagnoses and

nursing intervention.

Definition:

‘’ Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis’’

• Also known is Podagra.( when big toe OF THE leg are involved)

Signs and symptoms• Signs and symptoms include:a. Pain, swelling, warmth and tenderness at

the affected joint.b. reddish skin around the affected joint.c. Limited movement.d. Itching of the skin around the affected

joint.e. Usually acute pain at night time.

causes

• High level of ureic acid in the blood cause gout disease.

• inherited factors (genes) may also seem to play a role. (mutation in some genes encode protein which carry uric acid to the site of excreation)

Risk factors• Eating a diet rich with purine. Eg: meat and seafood.• Certain medicine: eg: diuretics.• Some disease. eg: Kelley-Seegmiller syndrome or Lesch- Nyhan syndrome.( difficiency of posphorybosylposphatase synthytase, hypoxainthain-guvanine phosphorybosyltransferase enzyme: regulate uric acid level in blood)

• Having a family history of gout

pathophysiology• Hypoxanthine uric acid

hyperurecemia urate crystallization of urate in the joint

GOUT

gout

Pain , swelling, redness, tenderness

diagnoses

• Synovial fluid aspiration.• Blood test.• WBC• ESR• RFTs• X-ray.

complicationThe person suffered by Gout is at increased risk of:• Hypertension• Diabetes.• neuropathy• Cardiovascular disease.Although these relationship are not fully well understood.

N P management• Foods that have very high purine levels

including hearts, liver, and kidney should be avoided.

• Advice to take low-fat or non-fat dairy products. Dairy products are relatively low in dietary purines. Milk also contains uricosuric factors, such as orotic acid, which may promote renal uric acid excretion.

P management• NSAIDS• Colchicine.• Steroid. corticosteroids • Xanthine oxidase inhibitor eg: block the action of

xainthain oxydase enzyme. eg Allopurinol.• Uricosuric drugs: (inhibit the reabsorption of uric

acid from the PCT of the kidney. eg Probenecid, Benzbromarone.

• Uricoslytics:(convert uric acid into water soluble compound)

Eg: Pegloticase, Rasburicase.

Epidemiology • Gouts affect around 1-2% of western

population.• Rates of Gout have approximately double B/w

1990 and 2010 due to change in diet and an increase in Gout associated diseases.

• the people of America and New Zealand are mostly affected.

• Some studies show that attack of gout occur in spring season.

Nursing diagnoses• Acute pain r/t tissue damage s/t gout.

• Impaird physical mobility r/t inflamation of the joints.

• Anxaity r/t disease process.

Nursing intervention• Administer the prescribed NSAIDS.

• Advice proper method for exercise.

• mind diversion therapy.

Summary

Any ? •

If you are doing GOOD work, don’t STOP. Press ON and keep working, no matter what other say or how much they DISCOURAGE you.