Uric Acid, Blood
Nursing Implications Procedure
- Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
- Patient Teaching: Inform the patient this test can assist in diagnosing gout and assessing kidney function.
- Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex. Especially note pain and edema in joints and great toe (caused by precipitation of sodium urates), headache, fatigue, decreased urinary output, and hypertension.
- Obtain a history of the patient’s genitourinary, hepatobiliary, and musculoskeletal systems; symptoms; and results of previously performed laboratory tests and diagnostic and surgical procedures.
- Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values).
- Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
- Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
- There are no food, fluid, or medication restrictions unless by medical direction.
- If the patient has a history of allergic reaction to latex, avoid the use of equipment containing latex.
- Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
- Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
- Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
- Promptly transport the specimen to the laboratory for processing and analysis.
- A report of the results will be made available to the requesting health-care provider (HCP), who will discuss the results with the patient.
- Nutritional Considerations: Increased uric acid levels may be associated with the formation of kidney stones. Educate the patient, if appropriate, on the importance of drinking a sufficient amount of water when kidney stones are suspected.
- Nutritional Considerations: Increased uric acid levels may be associated with gout. Nutritional therapy may be appropriate for some patients identified as having gout. Educate the patient that foods high in oxalic acid include caffeinated beverages, raw blackberries, gooseberries and plums, whole-wheat bread, beets, carrots, beans, rhubarb, spinach, dry cocoa, and Ovaltine. Foods high in purines include organ meats, which should be restricted. In other cases, the requesting HCP may not prescribe a low-purine or purine-restricted diet for treatment of gout because medications can control the condition easily and effectively.
- Recognize anxiety related to test results. Discuss the implications of abnormal test results on the patient’s lifestyle. Provide teaching and information regarding the clinical implications of the test results, as appropriate.
- Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Answer any questions or address any concerns voiced by the patient or family.
- Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.
- Related tests include arthroscopy, biopsy bone marrow, calcium, calculus kidney stone panel, cholesterol, collagen cross-linked telopeptide, CBC, CBC RBC count, CBC RBC indices, CBC RBC morphology, creatinine, creatinine clearance, gastrin stimulation, G6PD, lactic acid, lead, PTH, parathyroid scan, phosphorus, sickle cell screen, synovial fluid analysis, UA, US abdomen, uric acid urine.
- Refer to the Genitourinary, Hepatobiliary, and Musculoskeletal systems tables at the end of the book for related tests by body system.