A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?

Choice A reason:

Breast enlargement is not a known side effect of ginkgo biloba. This herbal supplement is primarily used for its potential benefits in improving cognitive function and circulation. There is no evidence to suggest that ginkgo biloba causes breast enlargement.

Choice B reason:

Decreased alertness is not typically associated with ginkgo biloba. In fact, ginkgo biloba is often taken to enhance cognitive function and alertness. It is believed to improve blood flow to the brain, which can help with memory and mental clarity.

Choice C reason:

Bad breath is not a common side effect of ginkgo biloba. While some herbal supplements can cause changes in breath odor, ginkgo biloba is not known to have this effect. Bad breath is more commonly associated with poor oral hygiene or certain foods.

Choice D reason:

Bleeding gums can be a side effect of ginkgo biloba. This supplement has blood-thinning properties, which can increase the risk of bleeding. People taking ginkgo biloba should be cautious if they are also taking other blood-thinning medications or have conditions that predispose them to bleeding.

Choice A reason: Diuretic use

Diuretic use can influence the formation of kidney stones, particularly certain types of diuretics that increase calcium excretion in the urine. However, this is not the most common or significant risk factor compared to others like family history or dietary habits. Diuretics such as loop diuretics can increase the risk of calcium stones by increasing calcium excretion.

Choice B reason: BMI less than 25

A BMI less than 25 is generally considered within the normal range and is not typically associated with an increased risk of urolithiasis. In fact, obesity is a more significant risk factor for kidney stones. Higher BMI is linked to increased excretion of stone-forming substances like calcium and oxalate.

Choice C reason: Hypocalcemia

Hypocalcemia, or low calcium levels in the blood, is not a common risk factor for urolithiasis. In fact, low dietary calcium can increase the risk of kidney stones because it leads to higher oxalate absorption in the gut, which can then form stones in the kidneys. Therefore, hypocalcemia is not typically associated with an increased risk of kidney stones.

Choice D reason: Family history

Family history is a significant risk factor for urolithiasis. If a close relative has had kidney stones, the likelihood of developing them increases. This is due to genetic predispositions that affect factors like urine composition and kidney function. Studies have shown that individuals with a family history of kidney stones are more likely to develop them themselves.