Exhibits
Client history has been collected, and the nurse performs a physical assessment and records vital signs.
Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.
Nonsmoker
Obesity
Drinks beer nightly
Daily aspirin
Type 2 diabetes mellitus
Sleep apnea
Ibuprofen for pain
Osteoarthritis
Correct Answer : B,C,E,F
A. Nonsmoker: Smoking does not directly contribute to the development of gout. While smoking is a risk factor for many health conditions, it is not a major contributor to the elevated uric acid levels associated with gout.
B. Obesity: Obesity is a well-established risk factor for gout because it leads to increased production of uric acid and reduced renal excretion of uric acid. Higher body fat increases the likelihood of developing hyperuricemia (elevated uric acid levels in the blood), which can form crystals in the joints, leading to gout.
C. Drinks beer nightly: Alcohol, particularly beer, is a significant risk factor for gout. Beer contains high levels of purines, which are broken down into uric acid in the body. Chronic alcohol consumption, especially beer, increases uric acid levels, contributing to the formation of uric acid crystals in the joints, which leads to gout attacks.
D. Daily aspirin: Aspirin, particularly at low doses, can reduce the excretion of uric acid by the kidneys, which can increase the risk of hyperuricemia and gout. However, this effect is typically observed with chronic, low-dose aspirin use, which is not indicated here in the patient's history.
E. Type 2 diabetes mellitus: Type 2 diabetes mellitus is associated with insulin resistance, which impairs the kidney's ability to excrete uric acid. As a result, uric acid builds up in the bloodstream, increasing the risk of gout. Additionally, people with type 2 diabetes often have comorbidities (such as obesity) that further increase the risk of gout.
F. Sleep apnea: Obstructive sleep apnea is associated with intermittent hypoxia (lack of oxygen), which can contribute to the production of uric acid and decreased renal clearance. This increase in uric acid levels raises the risk of hyperuricemia and subsequently gout. Sleep apnea can also be related to metabolic syndrome, which is another risk factor for gout.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Obtaining a sample of the drainage is not an immediate priority after evisceration; the patient's safety and stabilization come first.
B. Auscultating the abdomen for bowel sounds is important but secondary to addressing the immediate crisis of evisceration.
C. Preparing the client to return to the operating room is the priority action because evisceration indicates a surgical emergency that requires prompt intervention to repair the abdominal wall and prevent complications.
D. While additional sterile dressing supplies may be needed, addressing the evisceration takes precedence to prevent further injury and manage the patient’s condition.
Correct Answer is A
Explanation
A. The elevated heart rate and respirations suggest the client may be experiencing hypoxia, especially following a thoracotomy. Administering oxygen will help improve oxygen saturation levels and address potential respiratory distress.
B. While pain management is essential, the immediate concern is ensuring adequate oxygenation.
C. Administering IV fluids may be necessary but is secondary to ensuring the client's oxygenation.
D. Encouraging the client to splint and cough is important for preventing complications but does not address the immediate issue of vital signs indicating possible respiratory compromise.
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