A nurse is caring for a client with Meniere disease and restricts the following foods in the dietary plan.
Select all that apply.

Choice A rationale

Whole milk contains proteins like lactalbumin and casein which may actually help in the excretion of uric acid from the body. While it contains fats, low-fat or full-fat dairy is generally considered safe or even beneficial for gout patients because it does not contain high levels of purines. Therefore, avoiding milk is not a primary recommendation for managing gout symptoms or preventing painful flare-ups in the joints.

Choice B rationale

Orange juice is high in fructose, which can increase uric acid production by accelerating the breakdown of adenosine triphosphate. However, it is not as detrimental as alcoholic beverages or high-purine liquids. While monitoring fructose intake is wise for gout management, orange juice is typically not the first beverage a nurse would instruct a client to strictly avoid compared to alcohol, which has a much more significant impact on renal uric acid clearance.

Choice C rationale

Cherry juice is actually recommended for clients with gout because it contains anthocyanins which have potent anti-inflammatory properties. Studies suggest that cherry consumption is associated with a lower risk of gout attacks because it helps lower serum urate levels. Teaching a client to avoid cherry juice would be counterproductive to their treatment plan, as it is a natural remedy often used to decrease the frequency of painful inflammatory episodes.

Choice D rationale

Organic wine contains alcohol which is a major trigger for gout flares because it competes with uric acid for excretion in the kidneys. When the kidneys prioritize processing alcohol, uric acid levels rise in the blood, leading to crystal formation in the joints. Even organic versions contain ethanol, which increases purine nucleotide metabolism. Alcohol consumption also leads to dehydration, which further concentrates uric acid and facilitates the crystallization process.

Choice A rationale

This statement requires correction because cleaning the eyes with a single washcloth starting from the infected eye can easily spread the virus to the uninfected eye. Viral conjunctivitis is highly contagious. The correct technique involves using a clean part of the cloth or a separate cloth for each eye and always wiping from the inner canthus to the outer canthus to prevent cross-contamination between the eyes.

Choice B rationale

Frequent handwashing is an appropriate and essential action to prevent the spread of viral conjunctivitis. This statement does not indicate a need for more teaching. Since the virus is transmitted through contact with eye secretions or contaminated surfaces, maintaining hand hygiene helps protect others in the household and prevents the patient from re-infecting themselves or spreading the virus to other objects or people nearby.

Choice C rationale

This statement indicates a need for more teaching because sharing personal items like pillows, towels, or linens is a primary route for transmitting viral conjunctivitis. The virus can survive on surfaces for significant periods. To prevent the spread of infection to family members, the client should use their own bedding and wash it frequently in hot water to kill any viral particles present.

Choice D rationale

This statement requires further teaching because eye makeup, particularly mascara and eyeliner, becomes contaminated with the virus during use while the infection is active. Continuing to use the same makeup after the infection has cleared can lead to reinfection. Patients should be instructed to discard all eye makeup used during the infection and avoid using new products until the viral shedding has completely ceased.

Choice E rationale

This statement is generally accurate and does not necessarily indicate a need for more teaching in the context of typical viral conjunctivitis. Viral infections of the eye often take about seven to fourteen days to fully resolve, and returning to work or school after the acute symptoms and discharge have disappeared is standard advice. It reflects an understanding of the self-limiting nature of the viral infection.