Wu Yu Chang is currently working as a Nursing Practitioner in the Department of Trauma and Colorectal Surgery of Far-Eastern Memorial Hospital, New Taipei, Taiwan.

Maintaining the lithotomy position and operation time for more than 2~4 hours, may cause swelling and pain of the lower extremity due to acute compartment syndrome and deep vein embolism. A 65-year-old man suddenly felt lower extremity swelling and pain after undergoing six hours of colon cancer surgery in the lithotomy position. After a series of the workup, exclude acute compartment syndrome and deep vein thrombosis. The history of gout was confirmed, clinical symptoms are sudden left lower limb swelling and pain, redness and gradually confined to the left knee joint, hyperuricemia and the X-ray reveals left supra-patellar pouch with a product of synovial fluid. The clinical symptoms consistent with 2015 ACR and the European Union Rheumatology (European League Against Rheumatism, EULAR) diagnostic criteria for gout, gout was diagnosed. Following the clinical guidelines for gout, the symptoms are relieved within a week. In the literature, it was found that dehydration and insufficient water intake can trigger gout attacks. This case is in the process of preparing for colon cancer surgery, fasting before surgery, diarrhea caused by bowel preparation, water intake is not enough and intravenous fluid replacement is inadequate, these factors make acute gout is triggered. Based on this experience, recommended gout cases before undergoing bowel surgery,simultaneous monitoring of input and output when performing bowel cleansing, according to the monitoring results, provide appropriate intravenous fluids to ensure adequate body fluids, uric acid is excreted by the kidneys, reduce the acute episode of gout is triggered.

Wei Jun-Fen is working at Far-Eastern Memorial Hospital-Taiwan. Her research experience includes various programs, contributions and participation in different countries for diverse fields of study. She is a recipient of many awards and grants for her valuable contributions and discoveries. She is committed to highest standards of excellence and it proves through his work and experience

Dysphagia is common in stroke patients. It may cause dehydration, malnutrition, aspiration pneumonia and prolonged hospitalization. Thirty to sixty percent of patients with stroke had dysphagia. The Water Swallow Test (WST) is an easy bedside screening tool for nurses to evaluate aspiration risk in stroke patients. Swallowing training and nursing interventions, including active oral exercises, change of food textures, adjustment of eating posture, use of assistive devices and control of dining environments, can facilitate swallowing function recovery for stroke patient. With dysphagia evaluation skills and relevant nursing interventions, clinical nurses can improve the safety of swallowing training and reduce the incidence of aspiration pneumonia in stroke patients.