Acute Gout Attack Case Study

898 Words 4 Pages
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 should not have ordered Allopurinol. It is a serum urate lowering therapy for the prevention of gout, which is prescribed in patient who has one of the following: minimum of 2 flares per year except 1 per year in person with chronic kidney disease, tophi or history of nephrolithiasis (Hainer et al., 2014). In this case, this was patient’s first gout attack. I agree with the follow up of the patient in 24 hours for the evaluation. Then reevaluate in 2 weeks to see if hypertension and gout attack has been improving. (Cash, 2015). Referral to rheumatology is not necessary at this point because it is considered only if there is no clear cause of hyperuricemia, no response to NSAIDS in 2 days, difficulty reaching target serum uric acid level, and has a serious adverse reaction from urate lowering therapy (Rothschild, 2016). Also, I should have included notify provider if no symptom improvement after the start of NSAIDS in 2 to 3 days. I agree with my decision to start on amlodipine for the blood pressure and stopping the HCTZ. Amlodipine is a calcium channel blocker

Related Documents