Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Chronic gout and acute inflammation from gouty flares can lead to chronic pain, joint damage and potential disability. As the disease progresses, joints may look deformed due to the development of tophi.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Hyperuricemia is defined as serum urate concentrations greater than 6.8 mg/dL. At levels greater than 6.8 mg/dL, serum uric acid concentrations exceed the natural saturation point, which leads to the development of monosodium urate crystals.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Gout is an inflammatory condition that results from monosodium urate crystals precipitating in the synovial fluid between joints. The crystals form due to hyperuricemia either from overproduction or underexcretion of uric acid.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Gout is the most common form of inflammatory arthritis in the United States. The incidence of gout in America has increased over the last 20 years and is now estimated to affect 8.3 million Americans.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Historically, gout has been called the “disease of kings.” For years, gout was believed to be caused by an overindulgence in food and alcohol. While dietary factors can play a role, they are not the only factors leading to gout development.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Glucosamine, a form of amino acid, is a naturally occurring substance in the body. It is believed to be involved in the development and repair of cartilage. Exogenous replacement of this substance is thought to help build on existing cartilage.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Monitoring for NSAID therapy includes a complete blood count, urinalysis and serum creatinine. These studies should be repeated at 1 to 3 months and then every 3 to 6 months thereafter for the duration of therapy.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Many NSAIDs are pregnancy category C agents during the first 30 weeks of gestation. After gestational week 30, most NSAIDs are categorized as class D agents, indicating evidence of harm to the fetus.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Historically, acetaminophen 1 gram every 6 to 8 hours has been the first-line treatment for osteoarthritis (OA) due to its effectiveness in reducing the pain of OA within 4 weeks and lasting for up to 2 years.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
In 2012, the American College of Rheumatology published guidelines for treating hand, hip and knee osteoarthritis. For hand osteoarthritis, the initial recommended treatments are topical capsaicin, topical NSAIDs, oral NSAIDs and tramadol.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
If symptoms of osteoarthritis are restricted to one or two joints that have not responded to first- or second-line treatment, intra-articular corticosteroids may be helpful. Aseptic technique and a local anesthetic are required.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The mechanism of action for topical diclofenac is the same as for oral NSAIDs. The benefit is that minimal diclofenac is absorbed when applied topically, which then decreases the risk of adverse events.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Diclofenac is a commercially available topical NSAID. It is available as a 1.5% solution (Pennsaid) for the relief of osteoarthritis (OA) pain of the knee and as a 1% topical gel (Voltaren) for the relief of OA pain in joints amenable to topical therapy.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Capsaicin's most common adverse event is burning. The burning typically subsides within days of continual use. Due to the initial release of substance P, patients may experience some pain with initial use and should be advised to expect this.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Substance P is a chemomediator responsible for pain transmission from the periphery to the CNS. Therefore, by depleting peripheral neurons of substance P, the pain impulse will not be transmitted centrally.