A nurse in a provider's office is caring for a client who has a medical history of rheumatoid arthritis and psoriasis, and a family history of heart disease and arthritis. The client has a 60-year smoking history and denies alcohol or other substance use. They are positive for Helicobacter pylori and are on medication for peptic ulcer disease (PUD). Which three findings from the client's medical record increase their risk for peptic ulcer disease?

Choice A rationale
Restricting airplane travel is not typically necessary for patients on hemodialysis unless there are specific medical concerns or complications related to their condition.

Choice B rationale
Driving restrictions are not a standard restriction for patients with end-stage kidney disease unless there are other underlying conditions that impair the ability to drive safely.

Choice C rationale
Time constraints are a significant factor for patients on hemodialysis due to the frequent and lengthy treatment sessions, which can limit their availability for other activities.

Choice D rationale
Limiting social activities to twice a week is not a standard recommendation; social interactions are important for mental health and should be encouraged as much as the patient's health allows.

Choice E rationale
Restricting foods high in potassium, sodium, and phosphorus is crucial for patients with end-stage kidney disease to help manage electrolyte levels and prevent complications.

Choice F rationale

Restricting fluid intake is essential for patients on hemodialysis to prevent fluid overload, which can lead to heart failure and other serious health issues.

Choice A rationale

An increasing hemoglobin level does not indicate the resolution of acute pancreatitis. Hemoglobin levels can fluctuate due to various factors, including hydration status and blood loss, but are not directly related to the resolution of pancreatitis.

Choice B rationale

During an episode of acute pancreatitis, serum concentrations of amylase and lipase rise significantly, often within hours of pancreatic injury. These elevated enzyme levels are key components in diagnosing the condition. As the inflammation subsides and the pancreas begins to heal, the levels of these enzymes typically decrease, returning to normal ranges. Therefore, a declining serum amylase level suggests that the acute inflammatory process is resolving.

Choice C rationale

Serum bilirubin levels are indicative of liver function and bile metabolism. Elevated bilirubin may occur if pancreatitis leads to bile duct obstruction or liver involvement. However, a decrease in bilirubin levels addresses biliary system recovery rather than directly reflecting pancreatic inflammation resolution.

Choice D rationale

An increasing serum alkaline phosphatase level is generally associated with bile duct obstruction or bone disease and does not indicate the resolution of acute pancreatitis. This enzyme is found in several tissues throughout the body, including the liver and bones.