A nurse is planning care for a patient with gout.
What nursing intervention should be included in the plan of care for this patient?
Encourage the patient to consume a diet high in purines.
Administer diuretics to help eliminate excess uric acid.
Provide education on dietary modifications to reduce purine intake.
Instruct the patient to avoid hydration to prevent uric acid buildup.
The Correct Answer is C
Choice A rationale:
"Encourage the patient to consume a diet high in purines." Encouraging a high-purine diet is not appropriate for a patient with gout.
High-purine foods can lead to increased uric acid levels, exacerbating gout symptoms.
The goal is to reduce purine intake.
Choice B rationale:
"Administer diuretics to help eliminate excess uric acid." While diuretics can increase uric acid levels in some cases, they are not typically administered as a primary treatment for gout.
In fact, certain diuretics can exacerbate gout symptoms by raising uric acid levels.
They are usually avoided or used cautiously in gout management.
Choice D rationale:
"Instruct the patient to avoid hydration to prevent uric acid buildup." Instructing the patient to avoid hydration is not appropriate and can be harmful.
Proper hydration is essential for gout management because it helps flush excess uric acid from the body.
Dehydration can lead to increased uric acid concentration in the blood and may worsen gout symptoms.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A rationale:
"Are you taking any medications for pain relief?" This choice is not the most appropriate in this situation.
While it is important to address the patient's pain, understanding the medications aimed at treating the underlying cause, which is high uric acid levels, is more crucial.
Pain relief medications may provide symptomatic relief but do not address the root cause of gout.
Choice B rationale:
"Are you taking any medications to lower your uric acid levels?" This is the correct choice.
Gout is primarily caused by elevated uric acid levels in the blood, leading to the formation of urate crystals in the joints.
Lowering uric acid levels is a key component of managing and preventing gout attacks.
Asking about medications that target this aspect of the condition is essential for the patient's care.
Choice C rationale:
"Are you taking any medications to treat kidney stones?" This choice is not the most appropriate in this context.
While kidney stones can be associated with gout due to the deposition of urate crystals in the kidneys, the primary concern in gout management is to control uric acid levels and prevent joint inflammation.
Kidney stone treatment may be relevant but is not the immediate focus of care.
Choice D rationale:
"Are you taking any medications to promote weight loss?" This choice is not relevant to gout management.
While weight loss can be beneficial for some patients with gout, especially if they are overweight, it is not a primary medication-based treatment for the condition.
Lowering uric acid levels and managing pain are more critical aspects of gout care.
Correct Answer is A
Explanation
Choice A rationale:
"Acetaminophen" is the appropriate alternative for pain relief in a client with gout who is allergic to NSAIDs and cannot take corticosteroids.
Acetaminophen is a non-prescription pain reliever that can be used for pain management in gout and is not known to exacerbate gout symptoms.
Choice B rationale:
"Aspirin" is generally not recommended for gout pain relief because it may interfere with uric acid excretion and potentially worsen gout symptoms.
Choice C rationale:
"Ibuprofen" is an NSAID and may not be suitable for a client allergic to NSAIDs.
Choice D rationale:
"Naproxen" is also an NSAID and is not suitable for a client allergic to NSAIDs.
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