Gouty Arthritis

1 January 2017

Leadership in societal transformation I nterdependence with various stakeholders N urturing desire for harmony of man and nature College of Nursing, Dentistry, Pharmacy and Allied Health Sciences Vision NORSU College of Nursing as a educational institution or preference in the Visayan and Mindanao to become the premier provider of health care and education in the province, region and country. Mission NORSU College of Nursing provides excellent instruction thereby developing competent future health leaders and workers who are intellectually responsive, self-directing and contributing members of the society.

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Goals Develop innovative approaches to achieving quality teaching, research, service and practice goals. Contribute to the knowledge base of the discipline through an active program of health care and interdisciplinary research that is responsive to the changing health needs of the population. Cultivate the attitudes and skills necessary to the think critically, manage information and assume accountability for independent decision. Maintain awareness of historical trends and legal, social, economic, and political issues related to total health care education

To synthesize theoretical and empirical knowledge from the liberal arts and sciences with nursing science to enhance professional practice. To equip would-be health leaders and workers with comprehensive knowledge and skills in administering health services in various health settings. To stimulate the facility and students’ capacity to undertake quality research especially in identified priority areas, for the enhancement of the quality of human life and for local, regional and national development.

To establish collaborative and cooperative relationship for the purpose of modelling excellence in Nursing research service and practice. To value every individual as a unique, adaptive person who has worth and dignity and who engages in dynamic, reciprocal interaction with the environment, To collaborate with health consumers and providers in promoting, maintaining, and restoring health and facilitating the provision of accessible cost-effective, quality health care. Acknowledgement

We would like to thank to our beloved parents, for the unconditional financial support, understanding, guidance and love as well as the encouragement they have given to us in accomplishing this requirement and of course in pursuing our dreams. To our client and client’s significant others who patiently answer our questions and cooperate with us. To the staff in the Medicine Ward, who allowed and guided us throughout our duty. To the College of Nursing, Dentistry, Pharmacy, and Allied Health Sciences (CNDPAHS) headed by our motherly Dean Dr. Dalisay M. Dumalag, who molded us into a better and competitive student nurses.

To our clinical instructor in the Surgery Ward, Mrs. Girlie M. Odonel, who shares her expertise in the Medicine Ward , invaluable asset to the completion of this case presentation and for always answering our numerous questions and providing us with consistent words of encouragement. We would also like to extend a grateful thank to you, to our friends and colleagues batch 2013 at Negros Oriental State University (NORSU). And most of all, to our beloved God Almighty who gave us knowledge, wisdom, strength and presence of mind in doing this case presentation and for giving us life and another day to live.

TOPIC OUTLINE Topic Description: This case presentation deals with discussion about the disease condition of our patient who has Gouty with the emphasis on knowing the history of patient for the purpose of determining the prevalent cause of his disease condition, the different nursing care that are needed to be applied and the different concepts that will contribute to our knowledge about taking care of Patients under the disease condition known as Tophaceous Gouty Arthritis

The coverage of the topic includes the Patients Data, the history, the diagnosis, the interpretation of the Laboratory works, the overview of the Disease, the Musculo-skelletal system, the Renal System, the Pharmacologic and Non Pharmacologic interventions, the Growth and Development, the Psychological and Psychosocial data that was collected and gathered accurately for further study and analysis. General Objective:

At the end of the Case Presentation, the BSN III students of Negros Oriental State University under Medicine Ward Rotation will be able to gain knowledge, develop beginning Skills, Manifest Positive and Desirable Attitude towards the care of the client having Tophaceous Gouty Arthritis. Specific Objectives: At the end of the discussion, the BSN III student under Medicine Ward Rotation will be able to: 1. Understand thoroughly the disease process 2. Gain knowledge and ideas that is helpful for them if handling the same Disease condition of the patient 3.

Acquire informative behavior about the cause of the disease 4. Implement safe, effective and efficient Nursing Care Plan 5. Have an educative behavior, health promotive skills and efficient understanding about the presentation presented. Introduction Eating the right food, having an exercise and doing the right thing are the components of a good and healthy life. Disorders, as they say, are the ones that results from our carelessness and irresponsibility. Good Moring Everyone, we would like to discuss to you the disease condition of our Client who has Tophaceous Gouty Arthritis.

He is 54 years of age, and lives at Sta. Catalina Negros Oriental. He has one son and separated from his wife 10 years ago. He is a retired security guard of a government agency. Currently, he is the one who takes care of their small fishpond. According to him, they have heredo familial disease of having Gouty arthritis. His father suffered from this disease also. He is a heavy alcohol drinker, he is obese, he eats too much foods such as organ meats ( paklay ), more of beans and salty foods.

As a result, last 10 years ago, he developed signs and symptoms to quantify and quality Gouty Arthritis. He had his medical intervention and symptoms were relieved. But, he still continues his unhealthy diet, his alcoholism so that after 10 years, he developed Tophaceous Gouty Arthritis which is a terminal stage of gouty arthritis. He is experiencing severe pain and body malaise which urges him to seek medical intervention again. He is currently bed ridden, he has difficulty in flexing, and extending his joint and muscles, his body is so weak that he doesn’t want to move his self.

There are deposition of urate crystals on his skin and those were termed as tophus, plural is tophi. It is distributed to both upper and lower extremities. For more information of the disease process of our patient which includes the prognosis, please sit back and relax as we discuss to you those things that you need to know. Demographic Profile Name:Echavez, RosalitoDate of Admission:January 24, 2012 Age:54 years oldCivil Status: Separated Sex:MaleReligion:Roman Catholic Address:Sta. Catalina, Negros OrientalAttending Physician:Dr.

Paraiso Admitting Diagnosis:Tophaceous Gouty ArthritisWard:Extension Chief Complaint:Severe pain on the joints associated with body malaise and Hypertension General Appearance: * Received Client lying in bed, weak, body malaise, responsive to verbal and non verbal stimuli, irritable behavior noted and pain sensation felt on his joints especially on his big toe joint and his knee joint. Presence of bed wound laceration on his plantar area. With D5 IMB 1 L inserted at let metacarpal vein, running at 10 gtts/min; infusing well. Vital signs taken: 8:00am

T= 38. 4? C, P= 110 bpm, R= 36 cpm, BP= 150/90mmHg. 12:00 nn T= 38. 0? C, P= 115 bpm, R= 34 cpm, BP= 150/90mmHg. Present History of illness: * Patient was diagnosed of having Gouty arthritis 10 years ago, patient was advised to have a diet that will not increase uric acid level but patient failed to do so. Patient developed the signs and symptoms of gouty arthritis but this time it is in severe stage which is having tophi. Past History of Illness: * Has hospitalized 10 years ago, has completed childhood immunization, no allergies to food or drugs.

Has experienced common colds and taken OTC drugs to alleviate symptoms. Familial History of Illness: * Heredo familial disease of Hypertension and gouty arthritis Spiritual History: * Our patient is Roman Catholic in religion. He believed that God will provide answers for his prayers and provide solutions in all problems he have. His religion is very important for him, because God is the source of his strength and provide all needs in life. He considered that all things happen with a purpose and whatever it is he only trust God and offer all his suffering, sickness, and hurts.

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