A client who is obese reports severe pain and inability to bear weight in the right knee after making dietary changes 3 weeks ago for weight loss. The client's medical history includes hypertension, gouty arthritis, and cholecystitis. Which instruction should the nurse include in the discharge teaching?
Use electric heating pad when pain is at its worse.
Increase fluid intake to 2000 mL per day.
Exercise daily for at least 30 minutes.
Eat high protein foods to achieve ideal body weight.
The Correct Answer is B
A. Use electric heating pad when pain is at its worse: Heat can help relieve stiffness in arthritis, but during acute gout flares, applying heat may exacerbate inflammation. Cold therapy is generally recommended during severe joint pain episodes.
B. Increase fluid intake to 2000 mL per day: Adequate hydration helps prevent uric acid crystal formation, which can reduce the frequency and severity of gout attacks. Encouraging increased fluid intake is an important part of long-term management in clients with gouty arthritis.
C. Exercise daily for at least 30 minutes: While regular exercise supports weight loss and overall joint health, exercising during an acute flare can worsen pain and potentially injure the affected joint. Activity should be resumed gradually once inflammation subsides.
D. Eat high protein foods to achieve ideal body weight: High-protein diets, especially those rich in purines (e.g., red meat, organ meats), can exacerbate gout. Discharge teaching should focus on balanced nutrition with attention to foods that minimize uric acid levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Intubation tray: An intubation tray is necessary if the client experiences airway compromise or respiratory failure, but it does not directly address complications from an ineffective thoracentesis, such as persistent pneumothorax or pleural effusion.
B. Chest tube insertion tray: If the thoracentesis is ineffective and the pleural space continues to fill or air accumulates, a chest tube may be required to drain fluid or air and re-expand the lung. Having a chest tube tray ready ensures rapid intervention for these potential complications.
C. Crash cart: A crash cart is essential for emergencies involving cardiac or respiratory arrest, but it is not the first-line equipment for an ineffective thoracentesis unless the client acutely decompensates.
D. Ventilator: Mechanical ventilation may be required for severe respiratory failure, but it is not an immediate bedside intervention for an unsuccessful thoracentesis. The priority is to remove fluid or air from the pleural space.
Correct Answer is B
Explanation
A. Refer the caregiver to an audiologist: Referral to an audiologist is indicated if there are concerns about hearing loss, not for normal anatomical variations of the eustachian tubes.
B. Explain to the caregiver this is a normal finding: In toddlers, the eustachian tubes are naturally shorter and more horizontal, which predisposes them to ear infections. Educating the caregiver about this normal anatomy helps them understand the cause without unnecessary concern.
C. Discuss the importance of prophylactic antibiotics: Routine prophylactic antibiotics are not recommended for preventing recurrent ear infections due to normal eustachian tube anatomy, as overuse can lead to resistance.
D. Schedule the toddler for a tympanostomy procedure: Tympanostomy tubes are only considered for children with recurrent or persistent otitis media with effusion causing hearing loss or complications, not for normal anatomical predisposition alone.
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