A nurse is caring for a client who is pregnant.

The nurse is reviewing the client's medical record.
Select 4 findings that indicate a potential prenatal complication.

A. Dietitian: While nutrition can play a role in overall health and inflammation management, a dietitian referral is not the primary intervention for rheumatoid arthritis. Dietary counseling may be considered adjunctively but is not central to preserving joint function.

B. Case manager: A case manager helps coordinate care and resources, which may be helpful for complex cases, but referral is not specifically targeted to managing the functional impairments associated with rheumatoid arthritis.

C. Podiatrist: A podiatrist is consulted if the client develops foot or ankle complications. Routine referral is not indicated unless specific joint issues are present in the lower extremities.

D. Physical therapist: Physical therapy is essential in rheumatoid arthritis care to maintain joint mobility, reduce pain, and prevent deformities. A physical therapist develops individualized exercise programs, educates on joint protection, and supports functional independence, making this referral highly appropriate.

A. "I don't add salt to my food anymore.": Limiting sodium intake is appropriate for clients with chronic kidney disease (CKD) to help manage fluid retention and blood pressure. This statement reflects proper understanding and does not require additional teaching.

B. "I read nutrition labels before I buy something.": Reading nutrition labels helps clients monitor sodium, potassium, phosphorus, and protein intake, which is essential in CKD management. This demonstrates effective self-management and does not require further teaching.

C. "I'm eating larger portions of meat.": Consuming large portions of meat increases protein and phosphorus intake, which can worsen kidney function and complicate CKD management. This statement indicates a misunderstanding of dietary restrictions, and additional teaching is needed about appropriate protein portion sizes.

D. "I've started using olive oil instead of butter.": Replacing butter with olive oil is appropriate, as it provides healthier fats that do not contribute to hyperphosphatemia or cardiovascular risk. This reflects correct dietary adaptation and does not require further teaching.