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8 Cards in this Set
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A patient who has hypertension is taking a thiazide diuretic. The patient has a serum uric acid level of 8 mg/dl. The NP caring for this patient should |
Order a 24-hour urine collection. Patients who have hypertension or who take thighs I diuretics are at increased risk for gout. An elevated uric acid level alone is not diagnostic, and a 24-hour urine collection should be ordered. Colchicine should not be prescribed until the diagnosis is confirmed. It is not necessary to discontinue the size I diuretic. A referral to a specialist is not indicated. |
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A patient comes to the clinic reporting sudden pain and swelling of one knee joint. The NP suspects gout. When preparing to order diagnostic tests, the most important initial test the NP should order is? |
Synovial fluid aspirant for Gram stain and culture. Although the other tests are part of the diagnostic process, renal function, serum uric acid levels, 24-hour urine collection, the most important differential diagnosis to be made in a patient with gout is the exclusion of a septic joint. |
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Gout is diagnosed in a patient and test show the cause to be on under excretion of uric acid the NP should prescribe |
Probenecid, benemid. A uricosuric agent is indicated to increase the excretion of uric acid. Probenecid is a uricosuric medication. Febuxostat and Allopurinol are xanthine oxidase inhibitors. Colchicine is not a uricosuric agent |
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The NP prescribes probenecid to treat a patient who has gout. The patient comes to the clinic two weeks later with severe flank pain. The NP should? |
Ask the patient about fluid intake. Uricosuric agents are tubular blocking agents and decreased serum uric acid levels by increasing urinary excretion of uric acid. During the process, high concentrations of uric acid develop in the proximal renal tubules and may predispose the patient to the development of urinary stones. Patients should be encouraged to drink plenty of fluids. The patient who presents with flank pain should be questioned about fluid intake. If fluid intake is sufficient and renal stones are ruled out a UTI may be considered. Allopurinol is not indicated. NSAIDs are not indicated |
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A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. I had a follow-up visit, the patient's serum uric acid level is 7, and the patient denies any current symptoms. The NP should discontinue the probenecid and? |
Prescribed colchicine. Colchicine is a first-line drug for preventing acute attacks. Because this patient has three risk factors, a preventative medication should be used. Febuxostat is a second line preventative medication. The patient should not be treated on an as-needed basis |
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A patient with a history of gouty arthritis comes to the clinic with acute pain and swelling of the great toe. The patient is not currently taking any medications. The primary NP should prescribe? |
Naproxen. Naproxen is the first medication given for an attack of acute gouty arthritis to stop the inflammatory process. Pharmacologic treatment for hyperuricemia must be started after the acute attack has subsided |
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A patient who is taking colchicine for gout is in the clinic one week after beginning the medication. The patient reports decreased appetite and nausea. The NP should |
Discontinue the colchicine for 48 hours until symptoms subside. Colchicine toxicity causes nausea, vomiting and anorexia. When toxicity is suspected, the medication should be temporarily discontinued and restarted after symptoms subside |
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A patient who has a previous history of renal stones will begin taking probenecid for gout. The NP should |
Add colchicine to the patient's drug regimen. Patients at risk for urinary stones may take colchicine along with probenecid to reduce the risk caused by prevention. Salicylate and acidic urine increase the risk. The medication must be tapered six months after the last acute attack |
