Page 2153 - Saunders Comprehensive Review For NCLEX-RN

3. Glucocorticoids may be prescribed to reduce
inflammation during an acute gout attack (see
Chapter 47 for information on glucocorticoids).

4. Antigout medications should be used

cautiously in clients with gastrointestinal, renal,
cardiac, or hepatic disease.
B. Side and adverse effects
1. Headaches
2. Nausea, vomiting, and diarrhea

3. Blood dyscrasias, such as bone marrow

depression
4. Flushed skin and rash

5. Uric acid kidney stones

6. Sore gums
7. Metallic taste
C. Interventions
1. Assess serum uric acid levels.
2. Monitor intake and output.

3. Maintain a fluid intake of at least 2000 to

3000 mL/day to prevent kidney stones.
4. Monitor complete blood cell count and renal and liver
function studies.
5. Instruct the client to avoid alcohol and caffeine,
because these products can increase uric acid levels.
6. Encourage the client to comply with therapy to
prevent elevated uric acid levels, which can trigger a
gout attack.

7. Instruct the client to avoid foods high in

purine as prescribed, such as wine, alcohol, organ
meats, sardines, salmon, scallops, and gravy.
8. Instruct the client to take the medication with food to
decrease gastric irritation.
9. Instruct the client to report adverse effects to the
PHCP.

10. Caution the client not to take aspirin with

these medications, because this could trigger a gout
attack.
D. Nursing considerations
1. Allopurinol
a. Can increase the effect of warfarin and

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