Download Case Study: Management of Gout in a 71-year-old African American Male and more Exams Nursing in PDF only on Docsity! NR 324 Adult Health I RUA Case Study of a 71-year-old African American male with Gout {Chamberlain College of Nursing} TG is a 71-year-old African American male retired construction worker that is divorced with 3 children (2 girls & 1 boy). TG is overweight at 100.7 kg and 5’9 and says that he always feels stiff and has trouble exercising. He has no known allergies and is a full code. He has a history of gout, high blood pressure, and diabetes. His past surgeries include a kidney stone removal, a left hip replacement, and a right knee replacement. TG is on numerous medications including, but not limited to Aspirin, Simvastatin, Humalog, Gabapentin, Lopressor, and Allopurinol. He claims he misses his job and working and feels lonely. Claims he drinks about 1 pack of beer a day (6 or 12 cans). TG knows this isn’t a good lifestyle to have, but he feels okay about his way of life. Current Vital Signs Temp 99.0 degrees Fahrenheit orally Temp 97.8 - 99.1 degrees Fahrenheit BP 143/90 mmHg laying down BP 90/60 - 120/80 mmHg HR 75 bpm HR 60-100 bpm Resp 22 breaths/min Resp 12-18 breaths/min O2 96% on RA O2 91-100% Pain 8/10 Pain 0/10 Current Lab Values and Normal Lab Values Uric Acid 4.0-8.5 mg/dL Uric Acid 8.2 mg/dL Cholesterol 125-200 mg/dL Cholesterol 300 mg/dL HDL <40 mg/dL HDL 40 mg/dL LDL <100 mg/dL LDL 143 mg/dL Triglycerides <150 mg/dL Triglycerides 170 mg/dL TG has current lab values and vital signs to show for his health. His vital signs of blood pressure(143/90) and respirations(22) are concerning as they are both higher than normal. He does have a history of HTN and is on medications for it, but his high respiration rate could be from nerves. With his lab values, they are all higher than normal limits except for his uric acid which is on the borderline of normal limits. With this, his lab values are most concerning, as his history of high blood pressure is being controlled by medication. With his history of HTN and being overweight, he is more susceptible to experiencing gout from limited exercise (Roddy & Doherty, 2010). At this time, the doctor has ordered an X-ray of the affected foot, Pts serum uric acid levels, BMP, CMP, 24-hour urine samples, wear compression stockings, and wound care of the affected foot. A comprehensive assessment of TG was completed on admission. He has stated that three nights ago, his big left toe was in an immense amount of pain when he woke up that morning. He claims that ibuprofen and aspirin provided little to no help from the irritation and pain since that date. It looks as if the left big toe is swollen, red, stiff, and sensitive to touch and movement. As of right now, no other joints of the affected foot and leg seem to be affected. Pt does have limited ROM in his left big toe. Gout is diagnosed based on physical attributes and laboratory values. A
