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 D
Explanation
A. Instruct the client to cough as the suction tip is removed: While encouraging coughing helps clear secretions, it is not safe to ask a client to cough before suctioning; suctioning should be done with the catheter in place to remove secretions effectively.
B. Apply a water soluble lubricant to the catheter: Lubrication is not recommended for tracheostomy suctioning because it can introduce infection or interfere with effective suctioning.
C. Instill 3 mL of 0.9% sodium chloride before suctioning: Routine saline instillation is no longer recommended as it may increase the risk of infection, hypoxia, and airway irritation without improving secretion clearance.
D. Wear protective goggles while performing the procedure: Protective eyewear is essential to prevent exposure to secretions and reduce the risk of infection or contamination during tracheostomy suctioning.
Correct Answer is C
Explanation
A. Risk for fluid and electrolyte imbalance: While important, this risk is secondary to the immediate physiological consequences of insufficient nutrition. Electrolyte imbalances often develop as a result of malnutrition and require close monitoring.
B. Disturbed body image related to loss of control: Body image disturbance is central to anorexia nervosa, but it does not pose an immediate threat to life. Psychological interventions are essential but follow stabilization of physical health.
C. Imbalanced nutrition less than body requirements: Inadequate nutrition directly threatens physiological stability, affecting cardiovascular, gastrointestinal, and endocrine function. Restoring adequate nutrition is the highest priority to prevent life-threatening complications such as organ failure or severe electrolyte disturbances.
D. Impaired coping related to excessive physical activity: Excessive exercise may worsen malnutrition and stress, but it is secondary to the urgent need to correct nutritional deficits and stabilize the client’s physical condition.
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