Exhibits

The nurse is reviewing the client's medical record to better understand the previous gout attacks.

Click to indicate if the findings are consistent with an acute gout attack, chronic gout, or both. Each column may have more than one response. Each column must have at least one response selected.

Pain at the affected joint

Low grade fever

Occurs in more than 1 joint

Renal dysfunction

Visible tophi

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}

Pain at the affected joint

Acute gout attack: Yes. During an acute gout attack, the pain is typically sudden, intense, and localized to one joint, often the big toe.
Chronic gout: No. Chronic gout usually involves recurrent attacks over time, but the pain at any given moment may not be as intense or localized to a single joint unless there is a flare-up.

2. Low grade fever

Acute gout attack: Yes. During an acute attack, inflammation caused by uric acid crystals can lead to mild fever (100°F to 101°F).
Chronic gout: No. Chronic gout usually does not cause fever unless there is a secondary infection or other complicating factor.

3. Occurs in more than 1 joint

Acute gout attack: No. Typically, an acute gout attack involves only one joint, especially the big toe (podagra).
Chronic gout: Yes. Over time, gout can involve multiple joints, especially with untreated or poorly managed cases.

4. Renal dysfunction

Acute gout attack: No. Acute gout attacks generally do not cause renal dysfunction.
Chronic gout: Yes. Chronic gout can lead to kidney damage or urate nephropathy due to long-term hyperuricemia and uric acid crystal deposition in the kidneys.

5. Visible tophi

Acute gout attack: No. Tophi, which are uric acid crystal deposits under the skin, typically appear in later stages of gout, not during an acute attack.
Chronic gout: Yes. Visible tophi are a characteristic feature of chronic gout and occur after repeated and prolonged gout attacks, leading to the accumulation of uric acid crystals in soft tissues.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}

Explanation

Pain at the affected joint

Acute gout attack: Yes. During an acute gout attack, the pain is typically sudden, intense, and localized to one joint, often the big toe.
Chronic gout: No. Chronic gout usually involves recurrent attacks over time, but the pain at any given moment may not be as intense or localized to a single joint unless there is a flare-up.

2. Low grade fever

Acute gout attack: Yes. During an acute attack, inflammation caused by uric acid crystals can lead to mild fever (100°F to 101°F).
Chronic gout: No. Chronic gout usually does not cause fever unless there is a secondary infection or other complicating factor.

3. Occurs in more than 1 joint

Acute gout attack: No. Typically, an acute gout attack involves only one joint, especially the big toe (podagra).
Chronic gout: Yes. Over time, gout can involve multiple joints, especially with untreated or poorly managed cases.

4. Renal dysfunction

Acute gout attack: No. Acute gout attacks generally do not cause renal dysfunction.
Chronic gout: Yes. Chronic gout can lead to kidney damage or urate nephropathy due to long-term hyperuricemia and uric acid crystal deposition in the kidneys.

5. Visible tophi

Acute gout attack: No. Tophi, which are uric acid crystal deposits under the skin, typically appear in later stages of gout, not during an acute attack.
Chronic gout: Yes. Visible tophi are a characteristic feature of chronic gout and occur after repeated and prolonged gout attacks, leading to the accumulation of uric acid crystals in soft tissues.

Correct Answer is []

Explanation

Potential Condition

- Dilated Cardiomyopathy: This condition is most likely because the client presents with symptoms of heart failure (chest pain, dizziness, inspiratory crackles, systolic murmur, and ankle edema) alongside a history of hypertension, which can contribute to the development of dilated cardiomyopathy.

Actions to Take

1. Apply Oxygen: The client is showing signs of potential heart failure, and oxygen can help alleviate symptoms associated with decreased oxygenation.

2. Perform 12-lead EKG: An EKG will provide information about any potential cardiac abnormalities, especially in the presence of chest pain and systolic murmur.

Parameters to Monitor

1. Blood Pressure: It is essential to monitor blood pressure due to the client's hypertension and heart failure symptoms, which may be exacerbated by elevated blood pressure.

2. Urine Output: Monitoring urine output helps assess kidney perfusion and fluid status, which can be affected by heart failure and hypertension, particularly in cases of cardiomyopathy.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}

Explanation

Correct Answer is []

Explanation

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