Acute Gout Attack

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I agree with my decision to rest and elevate the joint area without any heavy lifting or weight bearing activity in the acute gout phase (Cash, 2015). I agree that the patient should increase intake of fluid to produce an output of 2L per day because it prevents development of uric acid kidney stones. I should have educated the patient about the disease process and, importance of NSAIDS for the treatment of an acute gout attack (Saccomano, 2015). I should have included apply ice packs 10 to 20 minutes during attack followed by warm compresses 2-3 times daily after acute pain for comfort. Aspirin should be avoided because it can cause gout. Weight loss is very important because it reduces risk of gout, hypertension, hyperlipidemia and left ventricular …show more content…
In addition, it is important to increase the consumption of vegetables and low fat or non-fat dairy products because it increases uric acid production as a byproduct of adenosine triphosphate catabolism. Also, it helps in the prevention of hypertension, hyperlipidemia and left ventricular hypertrophy. The goal of the treatment for an acute gout attack is to relieve pain and reduce inflammation (Saccomano, 2015). Acute gout attack can resolve on its own within a few days to several weeks. But anti-inflammatory helps to resolve the symptoms quickly. For gout exacerbation, NSAIDS are the first line treatment. Recommendations are indomethacin, naproxen, colchicine or oral corticosteroids. Starting treatment within 24 hours of symptom onset, provides complete resolution of the symptoms. Even though all NSAIDS are equally effective, indomethacin is commonly prescribed and preferred (Hainer et al., 2014). I should have included to discontinue the indomethacin 1 or 2 days after clinical signs have been completely resolved. Usually, NSAID therapy for an acute gout attack is 5 to 7 …show more content…
I agree to start the patient on Atorvastatin. According to American College of Cardiology (ACC) and American Heart Association (AHA) patient without diabetes, 40 to 75 years of age with an estimated 10 year ASCVD risk greater or equals to 7.5 should be started on statin therapy (Lambert, 2014). This patient had ASCVD risk of 21.3% and should have been started on moderate or high statin therapy. Atorvastatin 10mg is the moderate statin therapy. In addition, atorvastatin and simvastatin are the only statins that can reduce serum uric acid levels (Derosa, Maffioli, Reiner, Simental-Mendía & Sahebkar, 2016). I should have checked liver enzyme before the start of statin because statin can elevate the liver enzyme. Also, I should have included to check for fasting lipid profile in 4-6 weeks (Cash, 2015). Left ventricular hypertrophy is commonly seen in patient with uncontrolled hypertension and puts the patient at risk of heart attack and stroke. I agree with my plan for the left ventricular hypertrophy because lifestyle management by diet and exercise as well as hypertensive medication help prevent enlargement of the left ventricle (Mayo Clinic,

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