A client who is experiencing a first gouty arthritis attack reports excruciating pain in the right great toe. The nurse inspects the inflamed joint and administers ibuprofen 800mg PO as prescribed. Which instruction should the nurse include in the discharge teaching?

Replace dietary table salt with salt substitutes.

Encourage active range of motion to limit stiffness.

Take prescribed pain medication after exercising joints.

Avoid the consumption of wine, beer, and coffee.

Answer and Explanation

The Correct Answer is D

Choice A reason: Replacing dietary table salt with salt substitutes is not specifically related to managing gout. Gout is caused by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. The primary dietary factor influencing gout is purine intake, not sodium. While reducing sodium intake is generally beneficial for overall cardiovascular health, it does not directly impact uric acid levels or the management of gout. Therefore, recommending salt substitutes does not address the underlying cause or prevention of gout attacks. Moreover, some salt substitutes contain potassium chloride, which can have its own health implications, particularly for individuals with kidney issues.

Choice B reason: Encouraging active range of motion to limit stiffness is important for maintaining joint function in many conditions, but during an acute gout attack, the primary focus should be on reducing inflammation and pain. Gout attacks cause severe pain and swelling, particularly in the affected joint, and encouraging active movement during an acute phase can exacerbate the pain and inflammation. It is more appropriate to rest the affected joint and manage pain and inflammation with medications and other supportive measures. Once the acute phase has resolved, gradual reintroduction of movement and exercise can help maintain joint function and prevent long-term stiffness.

Choice C reason: Taking prescribed pain medication after exercising joints is not appropriate advice for managing gout. Pain medication, such as NSAIDs (nonsteroidal anti-inflammatory drugs), should be taken as prescribed by the healthcare provider to effectively manage pain and inflammation. It is crucial to follow the prescribed regimen for pain management, regardless of exercise or activity. Furthermore, during an acute gout attack, it is advisable to avoid activities that may aggravate the affected joint. Pain management should be proactive, and medications should be taken at regular intervals to maintain pain relief rather than in response to specific activities like exercise.

Choice D reason: Avoiding the consumption of wine, beer, and coffee is crucial for managing gout. Alcohol, particularly beer and wine, contains high levels of purines, which can increase uric acid production and exacerbate gout symptoms. Alcohol also promotes dehydration, which can lead to higher uric acid concentrations in the blood. Both of these factors can trigger gout attacks. Coffee has mixed effects on gout; while some studies suggest that moderate coffee consumption may not significantly impact uric acid levels, it is generally advised to be cautious with its intake. Educating the client to avoid or limit these beverages can help prevent future gout attacks and manage symptoms more effectively. Dietary modifications are a key component of gout management, and avoiding high-purine foods and beverages is essential in reducing the frequency and severity of gout attacks.

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Correct Answer is ["400"]

Explanation

Step-by-Step Calculation:

Step 1: Determine the total volume to be infused 100 mL

Step 2: Convert minutes to hours 15 minutes ÷ 60 minutes per hour = 0.25 hours

Step 3: Calculate the infusion rate in mL/hr 100 mL ÷ 0.25 hours = 400 mL/hr

Answer: 400 mL/hr

So, the nurse should program the infusion pump to deliver 400 mL/hr.

A. Painful areas should be rubbed gently until the pain subsides B. Enrolling in a pain clinic can provide pain relief alternatives C. Wearing gloves when handling cold items guards against painful spasms D. Return appointments will be needed for IV pain medication

Correct Answer is C

Explanation

Choice A reason: Rubbing painful areas gently may provide temporary relief, but it is not a specific or effective long-term management strategy for Raynaud's disease. This advice could lead to further discomfort if not done correctly, and it does not address the primary trigger, which is cold exposure.

Choice B reason: Enrolling in a pain clinic can provide pain relief alternatives, but this is a general recommendation and not specific to the management of Raynaud's disease. While pain clinics can be helpful for chronic pain management, practical daily interventions are also crucial for this condition.

Choice C reason: Wearing gloves when handling cold items is a direct and practical way to prevent painful spasms associated with Raynaud's disease. This condition is characterized by episodes of reduced blood flow to the extremities, typically triggered by cold temperatures. By wearing gloves, the client can protect their hands from cold exposure, which helps prevent these painful spasms.

Choice D reason: Return appointments for IV pain medication are not typical for managing Raynaud's disease. Pain management for Raynaud's generally focuses on preventive measures and lifestyle adjustments to avoid triggers, rather than relying on IV medications for pain relief.

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A client who is experiencing a first gouty arthritis attack reports excruciating pain in the right great toe. The nurse inspects the inflamed joint and administers ibuprofen 800mg PO as prescribed. Which instruction should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes 100 mL of 0.9% normal saline to be infused within 15 minutes. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["400"]

Explanation

A client who was recently diagnosed with Raynaud's disease is concerned about pain management. Which nursing instruction should the nurse provide?

Correct Answer is C

Explanation

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