Non-modifiable

Modifiable
Sex
Excessive
58 years old
consumption of organ
Hypertension stage II
meat, fatty foods and
ESRD sec to urate
alcohol
nepropathy

Purine breaks down into uric acid LEGEND

ESRD
Pathophysiology

Renal insufficiency Inability of the kidneys to excrete uric Signs and

acid symptoms

Impaired renal perfusion

Nursing diagnosis
Hyperuricemia
1. Instuct to follow strict Nursing
intervention
diet regimen.
2. Observe for edema.
3. Measure input and Increased levels of uric acid in the blood
Drugs
output of patient per stream
shift  
4. Weight patient daily. 

Uric acid deposits in the joints  Pain

Erythropoeitin

Acute pain
Initiation of the inflammatory response of
the body
Swelling 1.Adequate hydration.

Release of chemical mediators 2.Apply cold compress on

(cytokines, bradykinin, histamine, area during occurrence of
serotonin) pain.
1.Proper Positioning (keep joints
elevated with pillows)
Occurence of gout flare 
2.Apply cold compress on area
during occurrence of pain. Colchiline
Continuous and prolonged attacks of Paracetamol
gouty arthritis Aspirin

Continuous accumulation of excessive

uric acid in the joints, tissues, tendons, Impaired skin intergrity
Urate nephropathy
ligaments and body organs

Formation of tophi (large clumps of uric

acid) 1. Monitor skin for open
Multiple tophi on both arms, wounds and its
knees and ankles discharges.
2. Keep the area clean/dry,
Damages the bone and disfigures the carefully dress wounds.
joint 3. Instruct to pat skin only for
drying.
4. Dress wounds aseptically.
Multiple ulcerated tophi with brown 5. Emphasize importance of
Ulceration of the tophi adequate nutrition and
to yellow purulent exudate
fluid intake.

Mupirocin