Gout Disease, Research Paper Example

Musculo-Skeletal Nursing Care Competency

Gout disease is also referred to as Podagra. It is defined as a medical condition in which the sick person suffers from recurring attacks of severe inflammatory arthritis. The inflammation is characterized by hot, tender, red, swollen joint. Around 50% of this sickness cases attack the big toe’s base. Other cases are reported as urate nephropathy, tophi, or kidney stones (Terkeltaub, 2010). The main cause of this disease is high uric acid levels in a person’s blood, which crystallizes and then is deposited in tissues, tendons and joints.

Gout is diagnosed through a number of reasons, and then after the person is confirmed to be suffering from it, he should be treated at once. It is of paramount importance to note that the treatment of the person  suffering from gout can be started at once even before further diagnosis if it happens that the person shows symptoms of classic podagra or hyperuricemia (Richette & Bardin, 2010).

Nevertheless, when the patient’s sickness is in doubt, further diagnosis needs to be done through a number of ways. Synovial fluid is one of the best diagnosis that involves drawing of fluid by use of a needle from the infected joint. The fluid is tested for presence of monosodium urate crystals (MSU) (Terkeltaub, 2010). The identification of MSU crystals is done using polarized light microscope. If MSU crystals are present, they are symbolized by needle-like morphology. However, it should be noted that this diagnosis is complicated and needs to be performed very fast before the effect of PH and temperature on its solubility.

Gout diagnosis can also be conducted by blood tests. This method involves the determination of the level of uric acid in the blood with high levels associated with gout. Nonetheless, this method is sometimes misleading because there have been reports in which high uric levels have been reported but the persons are not suffering from gout. Similarly, there are people suffering from gout but with normal uric acid levels. In addition to the blood tests for uric acid levels, other tests are done on the blood including ESR (erythrocyte sedimentation rate), electrolytes, white blood cell count, and renal function. Just like the case of high uric levels, there are instances in which each of the above counts are abnormal but no signs of gout (Terkeltaub, 2010).

Gout diagnosis can also be done through differential method. The most common of the differential diagnosis is septic arthritis. This is mostly done to the patients who do not show signs of improvement even after treatment. To help the health care provider with diagnosis, synovial fluid gram stain is performed together with culture. This is usually done to confirm the presence of gout disease when the physician is in doubts and mistakes gout tophi for basal cell carcinoma simply because it is not in the joint of the patient (Tausche et al, 2009).

A person who predicts that he may be suffering from gout needs prepare before going to the hospital for diagnosis. The person suffering from other diseases such as hypertension, metabolic syndrome, diabetes mellitus and cardiovascular disease needs to be diagnosed with the best method that will not trigger the condition of the other illness (Richette & Bardin, 2010).

Before the test is done, the patient’s needs to be prepared with the kind of questions to ask from the physician and the possible outcomes. The patient should have a person to accompany him to the doctor. The patient should make a lists of the type of foods he eats so that the main cause of gout will be identified easily and recurring incidences of the disease prevented. The patient should try to remember any close relative who has ever suffered from the disease (Tausche et al, 2009).

During the diagnosis process, the physician should explain everything in detail to make the condition of the patient as clear as possible. Further, the patient should be allowed to ask all the questions he might have and clear answers given. The patient should also be encouraged to give the details of all the symptoms he is experiencing in order to lessen the diagnosis process. The patient should provide information of any other treatment of all other illnesses he is suffering from to ensure that the diagnosis done does not interfere with the other illness (Richette & Bardin, 2010).

After the diagnosis with the disease, the patient needs to start treatment immediately. The treatment should not in any case interfere with earlier treatments given. In addition, the patient diagnosed with gout needs to be directed on the types of food to eat to avoid recurring incidences. The physician needs to follow up the patient with the kinds of medications given so that they the drugs are changed in case they have severe side effects (Richette & Bardin, 2010).

It should be noted that patients diagnosed with gout needs to be treated at once. There are instances in which the patients may be unwilling to go for treatment in fear of the side effects. The symptoms of severe gout cases subsidize in five to seven days even without treatment. However, after some time, a second attack is witnessed with other serious risks associated. For this reason, it is advisable that the patient suffering from gout is encouraged to start treatment (Tausche et al, 2009).

The diagnosis of gout may be traumatizing especially when a patient is suffering from other related illnesses. It is also notable that gout leads to hypertension, metabolic syndrome, diabetes mellitus and cardiovascular disease increasing the risk of death of the patient. Additionally, the drugs administered have side effects and this makes the treatment of the disease almost impossible. With these factors, many people die from gout illnesses not because of its severity but rather other illnesses associated with it.

Even though there are a number of medications for people suffering from gout, three pharmacological interventions commonly used to treat a patient with this diagnosis include NSAIDs. NSAIDs are administered at high dosages for acute gout cases followed by lower dosages (Schlesinger, 2010). The dosage administration needs to be done for one to two weeks to show good results. It should be noted that it is such a good medication to the extent that positive results are seen after four hours of administration.

Gout can be treated using Colchicine with dosages given every after six hours. However, it has severe side effects that limit its usage. The side effects include nausea, diarrhea and vomiting. This limits its usage although it is preferred for the patients who cannot use NSAIDs (Tausche et al, 2009).

Another drug for gout is Corticosteroids, which is done through injection or pills (Schlesinger, 2010). It is recommended as the third option for people who cannot use NSAIDs or Colchicine. It has side effects limiting its usage including poor wound healing and thinning bones. The ability of the patient to fight diseases may also be reported.

Gout cases are increasing rapidly and especially in the Western, countries and need to be controlled through the best treatment methods. A patient should be followed even after treatment to ensure that the treatment done has no severe side effects.

References

Schlesinger, N. (2010). “Diagnosing and Treating Gout: A Review to Aid Primary Care Physicians.” Postgrad Med 122 (2): 157–61.

Terkeltaub, R. (2010). “Update on Gout: New Therapeutic Strategies and Options.” Nat Rev Rheumatol 6 (1): 30–8.

Tausche, A. K., Jansen, T. L., Schröder, H. E., Bornstein, S. R., Aringer, M. & Müller-Ladner, U. (2009). “Gout–Current Diagnosis and Treatment.” Dtsch Arztebl Int 106 (34–35): 549–55.

Richette, P. & Bardin, T. (2010). “Gout.” Lancet 375 (9711): 318–28.