A nurse is collecting data from a client who has an exacerbation of gout. Which of the following findings should the nurse expect? (Select all that apply.)
Tight skin
Edema
Tophi
Symmetrical joint pain
Erythema
Correct Answer : B,C,E
A nurse collecting data from a client who has an exacerbation of gout should expect to find edema, tophi, and erythema. Gout is a type of arthritis that occurs when urate crystals accumulate in the joints, causing inflammation and intense pain. Edema (swelling) is a common symptom of gout⁴. Tophi are deposits of urate crystals that can form under the skin in people with chronic gout³. Erythema (redness) is another common symptom of gout⁴.
a. Tight skin is not a common symptom of gout.
d. Symmetrical joint pain is not a common symptom of gout, as it usually affects only one joint at a time.
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Related Questions
Correct Answer is B
Explanation
The nurse should use the term "postictal phase" when documenting the client's difficulty arousing and sleepiness for several hours following a generalized tonic-clonic seizure. The postictal phase is the period of time immediately following a seizure during which the client may be difficult to arouse and very sleepy.
The presence of absence seizures, the presence of automatisms, and the aura phase are not appropriate descriptions for the nurse to use when documenting this finding in the medical record. Absence seizures are a type of seizure characterized by brief episodes of staring and unresponsiveness. Automatisms are repetitive, unconscious movements that can occur during a seizure. The aura phase is a warning sign that can occur before a seizure.
Correct Answer is D
Explanation
The nurse should expect to find edema of the toes first if the cast is too tight. A cast that is too tight can impede blood flow and cause swelling (edema) of the toes. If the nurse notices edema of the toes, they should report this finding to the provider and take appropriate action to prevent further complications.
Toes cool to touch may occur if the cast is too tight but this is not typically the first finding.
The inability to move toes may occur if the cast is too tight but this is not typically the first finding.
The pallor of the toes may occur if the cast is too tight but this is not typically the first finding.
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