A nurse is discussing gout with a patient who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? Select all that applies.
Depression
Deep sleep deprivation
Cardiovascular disease
Diuretic use
Correct Answer : C,D
Cardiovascular disease (CVD) is a significant risk factor for gout. This is because CVD often coexists with other conditions that can elevate uric acid levels, such as hypertension, obesity, and chronic kidney disease. Additionally, some medications used to treat CVD, such as thiazide diuretics, can also increase uric acid levels.
Research has shown that people with CVD have a 2-3 times higher risk of developing gout compared to those without CVD.
The mechanisms linking CVD and gout are complex and not fully understood, but they likely involve shared pathways of inflammation and endothelial dysfunction.
Choice D rationale:
Diuretic use, particularly thiazide diuretics, is a well-established risk factor for gout. These medications work by increasing the excretion of fluids and electrolytes from the body, which can also lead to a decrease in the excretion of uric acid.
This can result in a buildup of uric acid in the blood, which can then crystallize in joints and cause gout attacks.
The risk of gout associated with diuretic use is dose-dependent, meaning that higher doses of diuretics are associated with a higher risk of gout.
Choice A rationale:
Depression has not been consistently shown to be an independent risk factor for gout. Some studies have suggested a possible link between depression and gout, but others have not found any association. More research is needed to clarify the relationship between these two conditions.
Choice B rationale:
Deep sleep deprivation has not been studied as a risk factor for gout. There is currently no evidence to suggest that it is directly associated with an increased risk of developing the disease.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale:
Antinuclear antibody (ANA) titer is a blood test that detects the presence of antinuclear antibodies, which are autoantibodies that target the body's own tissues. These antibodies are often present in people with autoimmune diseases, including rheumatoid arthritis.
While a positive ANA test does not definitively diagnose rheumatoid arthritis, it can support a diagnosis when considered alongside other clinical findings and laboratory tests.
Choice B rationale:
Blood urea nitrogen (BUN) is a blood test that measures the amount of urea nitrogen in the blood. Urea nitrogen is a waste product that is produced when the body breaks down proteins.
BUN levels can be elevated in people with kidney disease, dehydration, or certain other medical conditions. However, BUN is not specifically used to diagnose rheumatoid arthritis.
Choice C rationale:
Urinalysis is a test that examines the urine for various substances, including cells, bacteria, and chemicals.
It can be used to diagnose a variety of conditions, including urinary tract infections, kidney disease, and diabetes. However, urinalysis is not typically used to diagnose rheumatoid arthritis.
Choice D rationale:
Erythrocyte sedimentation rate (ESR) is a blood test that measures how quickly red blood cells settle at the bottom of a test tube.
A high ESR can indicate inflammation in the body.
ESR is often elevated in people with rheumatoid arthritis, as it is a marker of inflammation.
Choice E rationale:
White blood cell count (WBC) is a blood test that measures the number of white blood cells in the blood. White blood cells are part of the immune system and help fight infection.
A high WBC count can indicate an infection or inflammation.
WBC count can be elevated in people with rheumatoid arthritis, as it is a marker of inflammation.
Correct Answer is A
Explanation
Choice A:
Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Activity intolerance is a common symptom, resulting in patients experiencing increased fatigue, pain, and decreased function with exertion.
A program of regular mild to moderate exercise is considered the cornerstone of management for fibromyalgia. Exercise improves physical fitness, reduces pain intensity, and enhances sleep quality. It also decreases fatigue and depression, and improves overall well-being and quality of life. The key is to start with low-impact activities, gradually increase intensity and duration over time, and listen to the body's signals to avoid overexertion.
Here's how exercise benefits patients with fibromyalgia:
Pain reduction: Exercise releases endorphins, natural pain-relieving chemicals in the brain. It also strengthens muscles and improves joint flexibility, leading to decreased pain intensity and frequency.
Improved physical fitness: Regular exercise increases cardiovascular health, muscle strength, and endurance, allowing patients to tolerate activity better and perform daily tasks with less fatigue.
Enhanced sleep quality: Exercise can regulate sleep patterns, promoting deeper sleep and reducing nighttime pain, leading to improved energy levels and mood throughout the day.
Reduced fatigue and depression: Exercise triggers the release of mood-boosting neurotransmitters, like serotonin and dopamine, which can help alleviate symptoms of depression and fatigue commonly associated with fibromyalgia.
Improved overall well-being: Regular physical activity enhances self-efficacy, reduces stress, and promotes social interaction, contributing to a better quality of life for patients with fibromyalgia.
Therefore, a program of regular mild to moderate exercise is the most effective recommendation for patients with fibromyalgia to address activity intolerance and improve their overall well-being.
Rationale for other choices:
Choice B: While daily meditation and guided imagery can be helpful for managing stress and improving sleep in fibromyalgia, they are not as effective as exercise in directly addressing activity intolerance and improving physical fitness and function.
Choice C: Referral to physical therapy for an assistive device may be necessary in some cases with severe limitations, but it is not the first-line intervention for addressing activity intolerance in most patients with fibromyalgia. Exercise should be the initial focus, with assistive devices considered later if needed.
Choice D: NSAID medications can offer temporary pain relief, but they do not address the underlying cause of activity intolerance in fibromyalgia and can have side effects like gastritis and kidney problems. NSAIDs should be used cautiously and only as a complementary therapy alongside exercise in managing fibromyalgia symptoms.
Remember, a tailored exercise program, starting with low-impact activities and gradually increasing intensity, is the key to managing activity intolerance and improving function in patients with fibromyalgia.
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