Question

Mr. Rogers is a 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 medical aspect of Mr. Rogers's right ankle to be reddened, slightly swollen, and warm. His temperature is within normal limits. He has strong pedal pulses 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.

1.  Explain what will facilitate a definitive diagnosis (cellulitis or gout) in Mr. Rogers's case?

2. If it is determined that Mr. Rogers has cellulitis, what treatments will the health care provider most likely describe?

3. If it is determined that Mr. Rogers has gout, what treatments will the health care provider most likely describe?

4. If the patient is diagnosed with gout, provide at least two examples of purine-containing foods and discuss appropriate fluid and alcohol intake to promote uric acid secretion.

Answer 1

1,According to the signs and symptms his diagnosis is Gout,the symptoms of gout are severe pain, redness and swellling in joints,like arthritis characterised severe pain.

2,Antibiotics is used to treat cellulitis, like, dicloxacillin, amoxicillin, cephalexin, or macrolide, like clarithromycin or azitromycin and penicillin, along with analgesics.

3,NSAIDs can help to reliece pain and shorten the duration of attack,diet modification,behavioural modification,such as increase exercise, reduce alcohol intake,and medications like Analgesics, uric acid regducer,anti inflammatory steroids also may help to reduce the symptoms.

4,The purine containing foods are, shelfish, like anchovies,sardines,herring,mussels,and some meats such as bacon,turkey, and organ meat like liver. Research found that both liquor and beer substantially increase blood uric acid level, beer intake seems to be associated with an increased risk of hyperuricemia in men. Drinking plenty of fluids help kidneys flush out uric acid faster.

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