Student Name: Dealon Rouse
| Patient Initials: JB
| Admission Diagnosis: Left Total Knee Arthroplasty &Excision of Left Knee Mass Related to Gouty Arthritis
| Date(s) of Care: 11/10/11- 11/12/11
| Age: 46
Date of Admission: 11/10/11
| Gender: Male
Marital Status: Married
| Room #: 507
| Code Status: Full Code
| Occupation: Electrician
| Race: Hispanic
| Isolation Type:
| Religion: Roman Catholic
| Allergies: No Known Allergies
History of Present Illness: The patient is a 46-year-old male diagnosed with right and left knee gouty arthritis. The patient in the past has undergone a right total knee arthroplasty. After more than 6 months of severe pain in the left knee, the growth of a mass along the anterior aspect of the left knee, and limitation of motion of the left knee, the decision was made that the patient undergo left total knee arthroplasy and excision of the left knee mass.
| Medical History:Consistent with gout of the left and right knees and right elbow – pain and extreme swelling in the left and right knees and right elbow.
| Surgical History:The patient stated that he had right total knee arthroplasty in 2007, and no other previous surgeries.
| Family History:The patient stated that there was no family history of gouty arthritis or total knee arthroplasy that he was aware of.
| Living Arrangements/Role in Family/Support Systems:The patient stated that he lives with his wife and no children. His wife will be taking care of him upon discharge. He will receive disability pay until he is able to return to work. His wife plans on taking one week off of work, but cannot financially afford to stay home any longer.
| Culture:The patient is originally from Mexico and has been living in Houston for 23 years. He is fluent on both Spanish and English and he practices both American and Mexican customs.
| Spirituality:The patient is a baptized Roman Catholic. He stated that he attends church for “weddings, funerals, and holidays”.
| Erikson’s Stage of Development: (Identify which stage your patient is currently experiencing):Generativity vs. Stagnation (Middle Adulthood, 40 to 65 years)
RNSG 1360 Nursing Assessment
Pathophysiology of Diagnosis (not the definition ) - * Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation. (Gout, 2010) * Acute gout is a painful but temporary condition that typically affects one joint. (Gout, 2010) * Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint. (Gout 2010)The patient has been diagnosed with chronic gout, affecting both knees and his right elbow.
| Etiology * Uric acid is generated as we metabolize the food we eat and as the body's tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid (10% of those affected), while other people with gout do not effectively eliminate their uric acid into the urine (90%). Genetics, gender, and nutrition play key roles in the development of gout. Gout is not contagious. (Rothschild, 2011) * Intake of alcoholic beverages, especially beer, increases the risk for gout. (Rothschild, 2011) * Diets rich in red meats, internal organs, yeast, and oily fish increase the risk for gout. (Rothschild, 2011) * Uric acid levels increase at puberty in men and at menopause in women, so men first develop gout at an earlier age than women do. Gout in premenopausal women is distinctly unusual. (Rothschild, 2011)The patient stated that he has no family history of gout and does not drink, but his diet is rich in red meats and oily fish.
Signs & Symptoms (circle or highlight those your patient exhibits) *
The first symptom of gouty arthritis is typically the sudden onset of a hot, red, swollen joint. The most common joint involved is at the base of the big toe where swelling can be associated with severe tenderness, but almost any...
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