Question

While performing otoscopic examination in a patient with gout, the nurse finds that the patient has small, whitish-yellow nodules and uric acid crystals in the ear helix. What information will the nurse document in the patient's chart?

The patient has tophi.

The patient has a keloid.

The patient has battle sign.

The patient has a sebaceous cyst.

Answer 1

The nurse would document the presence of small, whitish-yellow nodules and uric acid crystals in the patient's ear helix as tophi, indicative of chronic tophaceous gout.

Step-by-step explanation:

In the case of a patient with gout, the nurse's finding of small, whitish-yellow nodules and uric acid crystals in the ear helix during an otoscopic examination would typically be documented as tophi. Tophi are deposits of monosodium urate crystals and occur in chronic tophaceous gout. This symptom is indicative of advanced gout where urate crystal deposits build up in soft tissue areas, such as the ear helix. Tophi in the ear are not to be confused with keloids, battle sign, or sebaceous cysts, which are other types of ear and skin conditions.

Gout itself is characterized by the excessive accumulation of uric acid in the body, leading to the formation of these crystals depositing in the joints and potentially causing intense pain and swelling. Managing gout often involves dietary changes to reduce purine intake, since purines can increase uric acid levels. The intake of foods and beverages like tea, coffee, and chocolate, which contain purine-like compounds called xanthines, should then be minimized.