A 47 – year – old man presents with “extreme” pain in his right large toe. The man is overweight and. Question
Answered step-by-step
Asked by Firlygirl
A 47
–
year
–
old man presents with “extreme” pain in his right large toe. The man is overweight
and has consumed 12 to 16 beers daily for at least 15 years. His medical history includes
hyperlipidemia and a history of gall bladder
disease but is otherwise unremarkable. Today’s vital
signs include blood pressure 180/96, heart rate 89, respiratory rate 24, Temperature 98.8
F, and
pain reported as 8 on 1 to 10 scale. The patient has taken acetaminophen and ibuprofen for pain
management
with little effect. The patient says this is the first time he has experienced such pain.
He has not been diagnosed with gout, arthritis, or other conditions in the past. This pain has
prevented him from sleeping for 3 nights, and he appears tired. He als
o reports difficulty walking
and completing his daily responsibilities as a farmer. The patient reports recent trauma to the toe
as he dropped a heavy object on it 1 week prior; however, no obvious displacement of the joint
or bruising is noted. The practi
tioner suspects gout is the cause of the man’s condition.
Case Questions
1.
What risk factors does the man have for developing gout?
2.
What contributing factors shoul
d be explored with the patient?
3.
What physical assessment should be
performed
related to the
reported pain?
4.
What is the initial testing that should be
performed
after a physical assessment?
5.
What are the differential diagnoses for this patient?
6.
What modifications should the patient be instructed to make for treatment of the gout?
SCIENCE
HEALTH SCIENCE
NURSING
A 47 – year – old man presents with “extreme” pain in his right large toe. The man is overweight and
