A nurse is caring for a client with an acute gout flare. Which nursing diagnosis should be addressed first?

A. Take acetaminophen every 4 hr, as needed, for discomfort: Acetaminophen is hepatotoxic at high doses and should be used cautiously in clients with hepatitis B. Routine dosing without provider guidance can worsen liver injury. Safer alternatives or provider-approved dosing should be recommended.

B. Rest frequently throughout the day: Fatigue is a common symptom of hepatitis B, and frequent rest helps conserve energy and supports liver recovery. Adequate rest is a key component of self-care and symptom management.

C. You may donate blood 6 months after completing the medication regimen: Clients with hepatitis B should never donate blood while infected or until cleared and confirmed by a healthcare provider. Blood donation is strictly contraindicated during infection to prevent transmission.

D. Consume a high-protein diet: While adequate protein supports recovery, excessive protein intake may increase the liver’s metabolic load, particularly if hepatic function is impaired. Diet should be balanced and individualized rather than high-protein by default.

A. "Sunlight reduces joint inflammation in lupus.": Ultraviolet (UV) light does not reduce inflammation in lupus. Exposure to sunlight can actually exacerbate systemic and cutaneous symptoms.

B. "Sun exposure improves vitamin D and prevents flares.": While sunlight supports vitamin D synthesis, in lupus, UV exposure increases the risk of disease flares and skin lesions. Vitamin D should be obtained through diet or supplements rather than intentional sun exposure.

C. "UV light can trigger lupus flares and worsen skin lesions.": Ultraviolet radiation can activate the immune system in individuals with lupus, leading to inflammation, rashes, and systemic flares. Avoiding sun exposure and using protective measures are essential parts of self-care to prevent exacerbations.

D. “Photosensitivity is only a minor concern in lupus.": Photosensitivity is a major concern for many clients with lupus. Dismissing it can result in flares, worsening rashes, and increased risk of organ involvement. Patient education on sun protection is critical.