Colchicine 1200 mcg orally is prescribed for client with gout. Each table contains 0.6 mg. How many tablets should the nurse administer?
What should the nurse consider as the goal of therapy when administering allopurinol (Zyloprim) to a client with gout?
Increase bone density
Decrease synovial swelling
Decrease uric acid production
Prevent crystallization of uric acid
The Correct Answer and Explanation is:
Question 1: Dosage Calculation
Prescribed dose: 1200 mcg
Tablet strength: 0.6 mg
First, convert the prescribed dose to milligrams (mg) because the tablet is in mg:
- 1200 mcg = 1.2 mg
Now calculate how many tablets the client needs:
- Each tablet = 0.6 mg
- 1.2 mg0.6 mg/tablet=2\frac{1.2\text{ mg}}{0.6\text{ mg/tablet}} = 2 tablets
✅ Answer: 2 tablets
Question 2: What should the nurse consider as the goal of therapy when administering allopurinol (Zyloprim) to a client with gout?
✅ Correct Answer: Decrease uric acid production
Detailed Explanation (300+ words)
Gout is a type of inflammatory arthritis that occurs due to elevated levels of uric acid in the blood (a condition known as hyperuricemia). When uric acid accumulates, it can crystallize and deposit in joints, leading to the hallmark symptoms of gout: painful swelling, redness, and stiffness, typically affecting one joint at a time (often the big toe).
Allopurinol (Zyloprim) is not used to treat acute gout attacks but is part of the long-term management strategy. It works by inhibiting xanthine oxidase, an enzyme responsible for converting purines into uric acid. By blocking this enzyme, allopurinol reduces the overall production of uric acid in the body.
Therefore, the primary therapeutic goal when administering allopurinol is to decrease uric acid production, which in turn helps to:
- Lower serum uric acid levels
- Prevent the formation and deposition of urate crystals
- Reduce the frequency and severity of future gout attacks
- Prevent the development of tophi (hard uric acid deposits under the skin)
- Protect renal function by reducing the risk of uric acid nephropathy
Let’s look at the other answer choices:
- Increase bone density: This is unrelated to gout and is more relevant to osteoporosis.
- Decrease synovial swelling: While this may be a secondary benefit, it is not the primary mechanism or goal of allopurinol therapy.
- Prevent crystallization of uric acid: Though it’s an eventual outcome, this occurs as a result of reduced uric acid levels, not the direct pharmacological action.
In conclusion, decreasing uric acid production is the foundational goal of allopurinol therapy, helping to prevent gout flares and long-term complications. Nurses should educate clients that this medication is used for prevention, not for treating active attacks, and that it must be taken consistently even when symptoms are absent.