Gout Case Study (45 min)
Included In This Lesson
Study Tools For Gout Case Study (45 min)
Outline
Mr. Sampson is a 62-year-old male who presents to the Emergency Department (ED) complaining of severe right knee pain x 3 days. His gait is unsteady and he is limping and guarding that right leg. When the nurse walks in the room, he tells the nurse he has a history of Hepatitis C and HIV.
Upon further assessment, Mr. Sampson’s right knee is very swollen, reddened, and warm and tender to the touch. Mr. Sampson reports that his joints swell up like this all the time, and proceeds to show the nurse his hands, where she notes a swollen nodule on the left wrist, and two swollen nodules on the proximal knuckles of the right hand. The provider orders X-rays of the right knee and bilateral hands, as well as some basic laboratory tests, including an ESR and CRP. When the nurse goes to draw blood, she notes another swollen nodule over the patients left elbow that is shiny and has two white spots on it. She now knows that she needs to recommend one more test for the provider to order. The joint x-rays show crystal deposits around the swollen joints, and Mr. Sampson’s uric acid level is elevated significantly. When asked if he has a history of gout, Mr. Sampson replies “oh yeah, that, too.” He reports that he drinks wine daily. After 2 days of anti-inflammatory treatments and physical therapy assistance, Mr. Sampson’s joint swelling has decreased and he is able to walk easily without pain and will be discharged home today. The nurse is concerned that he may not understand what triggers his gout flare ups, considering how frequently he reports that they happen.
What initial nursing assessment should be performed at this time?
What are the possible diagnosis that should be explored for Mr. Sampson at this time?
What laboratory or diagnostic tests should be performed for Mr. Sampson?
What is the significance of the finding on the patient's elbow?
What other lab test should be added to confirm this diagnosis?
Explain what is going on with Mr. Sampson physiologically.
What medications do you anticipate the provider ordering for Mr. Sampson?
What discharge teaching should be included for Mr. Sampson to help him reduce the frequency of his flare-ups?
Rina’s NCLEX Study Plan
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Circulatory System
- Cardiac Disorders
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Basics of NCLEX
- Test Taking Strategies
- Respiratory Disorders
- Hematologic Disorders
- EENT Disorders
- Basics of Chemistry
- Adult
- Medication Administration
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Anxiety Disorders
- Renal Disorders
- Prenatal Concepts
- Vascular Disorders
- Gastrointestinal Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Immunological Disorders
- Sexually Transmitted Infections
- Upper GI Disorders
- Microbiology
- Labor and Delivery
- Communication
- Proteins
- Newborn Care
- Hematologic System
- Urinary Disorders
- Eating Disorders
- Musculoskeletal Disorders
- Bipolar Disorders
- Terminology
- Pregnancy Risks
- Concepts of Population Health
- Factors Influencing Community Health
- Postpartum Complications
- Prioritization
- Psychotic Disorders
- Basics of Human Biology
- Neurologic and Cognitive Disorders
- Labor Complications
- Writing
- Statistics
- Community Health Overview
- Dosage Calculations
- Musculoskeletal Trauma
- Neurological Trauma
- Note Taking
- Cardiovascular Disorders
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Cognitive Disorders
- Depressive Disorders
- Developmental Considerations
- Shock
- Documentation and Communication
- Legal and Ethical Issues
- EENT Disorders
- Fundamentals of Emergency Nursing
- Emotions and Motivation
- Renal and Urinary Disorders
- Digestive System
- Integumentary Disorders
- Intraoperative Nursing
- Fetal Development
- Basics of Mathematics
- Prenatal and Neonatal Growth and Development
- Childhood Growth and Development
- Preoperative Nursing
- Postoperative Nursing
- Neurological Emergencies
- Understanding Society
- Somatoform Disorders
- Reading
- Emergency Care of the Neurological Patient
- Infectious Respiratory Disorder
- Metabolism
- Oncologic Disorders
- Developmental Theories
- Basics of Sociology
- Emergency Care of the Trauma Patient
- Med Term Basic
- Med Term Whole
- Suffixes
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Newborn Complications
- Male Reproductive Disorders
- Adulthood Growth and Development
- Perioperative Nursing Roles
- Concepts of Pharmacology
- Endocrine System
- Postpartum Care
- Trauma-Stress Disorders
- Psychological Disorders
- State of Consciousness
- Shock
- Skeletal System
- Learning Pharmacology
- Hematologic Disorders
- Prefixes
- Delegation
- Tissues and Glands
- Personality Disorders
- Basic
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Integumentary Important Points
- Reproductive System
- Psychological Emergencies
- Growth & Development
- Intelligence and Language
- Pediatric
- Sensory System