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 ["B","C"]
Explanation
Inflammation occurs when uric acid crystals are deposited in the joints, causing the body to react with an inflammatory response.
Pain is a hallmark symptom of an acute gout attack due to the inflammation and the sharp uric acid crystals irritating the joint tissues.
Correct Answer is A
Explanation
A. Acute pain is the most immediate and pressing problem for the client, given the reported severe flank pain. Managing pain effectively is a primary concern in nursing care, particularly for clients with renal calculi.
B. While impaired renal function is a concern with renal calculi, the acute pain takes precedence as it requires immediate intervention to enhance the client's comfort and promote better overall health.
C. The risk for aspiration is a potential issue due to nausea and vomiting; however, addressing the pain is more urgent in this scenario.
D. Nutritional deficit related to nausea is also a valid concern but is secondary to the acute pain management. The client’s immediate comfort and pain relief should be prioritized to facilitate recovery and improve overall well-being.
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