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

Answer and Explanation

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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Correct Answer is C

Explanation

Choice A rationale:
While inquiring about pre-seizure symptoms can be informative, it's not the most crucial question at this point. The priority is to gather information about medication adherence to assess potential causes for the breakthrough seizure.

Choice B rationale:
Assessing for post-ictal fatigue is important, but it's not the most pressing question in the immediate aftermath of a seizure. Determining medication adherence takes precedence.

Choice D rationale:
Establishing whether consciousness was lost can aid in classifying seizure type, but it's not as critical as understanding medication adherence in the initial assessment.

Choice C rationale:
This question directly addresses a potential cause of the seizure. Understanding when the client last took their medication can help determine if missed or delayed doses contributed to the seizure, guide medication adjustments, and inform further seizure prevention strategies.

A. Provide a urine sample to determine therapeutic levels of the medication B. Take the medication at the same time every day C. Watch for bleeding gums when taking the medication D. Consider taking an antacid when on this medication

Correct Answer is B

Explanation

Choice A rationale:
Providing a urine sample to determine therapeutic levels of phenytoin is not typically a part of routine discharge instructions. While monitoring of phenytoin levels is important, it's usually done through blood tests, and the frequency of testing is determined by the healthcare provider based on individual patient factors.

Choice C rationale:
Bleeding gums are not a common side effect of phenytoin. While some individuals might experience gum tenderness or overgrowth, significant bleeding is not expected.

Choice D rationale:
Antacids can actually interfere with the absorption of phenytoin, potentially reducing its effectiveness. Therefore, it's generally not recommended to take antacids regularly while on phenytoin therapy. If a patient needs to take an antacid for occasional heartburn or indigestion, it's best to take it at least 2 hours before or after the phenytoin dose.

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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.

Choice D rationale:

Choice A rationale:

Choice B rationale:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of seizures is being admitted to the emergency room after experiencing a partial seizure. Which question would be most appropriate for the nurse to ask the client?

Correct Answer is C

Explanation

The nurse is providing discharge instructions to a patient who has a prescription for phenytoin. Which of the following information should the nurse include?

Correct Answer is B

Explanation

A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include?

A nurse is caring for a client who requests prescription pain medication. Which of the following actions should the nurse perform first?

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A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen?