[Answered]: CASE STUDY 1 # Long-term care ETHNICITY ☐ White…

CASE STUDY 1 # Long-term care ETHNICITY ☐ White American CULTURAL CONSIDERATIONS SOCIOECONOMIC ■Long-term care resident for past nine years SPIRITUAL/RELIGIOUS PHARMACOLOGIC ☐ Colchicine; allopurinol (Alloprim); probenecid (Benemid); LEGAL sulfinpyrazone (Anturane) PREEXISTING CONDITIONS ☐ Benign prostatic hypertrophy (BPH); gout COEXISTING CONDITION ETHICAL ALTERNATIVE THERAPY PRIORITIZATION COMMUNICATION ICATION ☐ Alert and oriented to person, place, and time DISABILITY DELEGATION Nursing collaboration with the dietician THE ENDOCRINE/METABOLIC SYSTEM Level of difficulty: Easy Overview: The client’s symptoms are consistent with cellulitis. His history, however, necessitates consideration of the possibility of a recurrence of gout. The case requires the nurse to consider the defining characteristics of cellulitis and gout. Treatment options are discussed for the two possible diagnoses. Nursing priorities are considered following a definitive medical diagnosis. 101 102 Part 8 THE ENDOCRINE/METABOLIC SYSTEM Client Profile Case Study Mr. Rogers is an 91-year-old resident of a long-term care facility who tells the nurse, “I have an ache in my right foot.” He offers an explanation, suggesting, “I must have stepped on something or twisted my ankle. Maybe I got bit by a bug when I was outside yesterday.” The nurse notes the medial aspect of Mr. Rogers’s right ankle is reddened, slightly swollen, and warm. His temperature is within normal limits. He has a strong pedal pulse bilaterally. Mr. Rogers’s ankle is X-rayed and there is no fracture noted. He has full range- of-motion of his right ankle and lower extremity, although the pain in his ankle increases with movement. A Doppler ultrasound rules out a deep vein thrombosis. Questions 1. Prior to the Doppler ultrasound, how could the nurse explain this diagnostic procedure to prepare Mr. Rogers? 2. Define cellulitis and discuss its common manifestations. 3. Briefly explain what gout is and describe the causes of primary and secondary gout. 4. What are the common characteristics of each of the four stages of gout? 7. If Mr. Rogers’s symptoms are diagnosed as a recurrence of gout, what treatments will the health care provider most likely prescribe? Consider short- and long-term treatment. 8. The nurse collaborates with the dietician to adjust Mr. Rogers’s diet to decrease his uric acid levels. Provide at least two examples of purine- containing foods and discuss appropriate fluid and alcohol intake to promote uric acid secretion. 5. Explain what will facilitate a definitive diagnosis 9. Write a nursing diagnosis the nurse will consider (cellulitis or gout) in Mr. Rogers’s case. 6. If it is determined that I what treatments will I the h Rogers has cellulitis, care provider most adding to Mr. Rogers’s plan of care upon learning the definitive diagnosis is gou