A nurse is educating a client with type 2 diabetes about self-monitoring of blood glucose. Which statement by the client indicates a need for further teaching?

Choice A reason: Hepatitis, an inflammatory liver condition, is managed medically with antivirals or supportive care, not surgically with a Whipple procedure. The Whipple involves pancreatic, duodenal, and biliary resection, irrelevant to hepatitis, which primarily affects liver parenchyma, making this an incorrect indication for the procedure.

Choice B reason: The term "cancer" is too broad. The Whipple procedure is specific to pancreatic or periampullary cancers, not all cancers. Without specificity, this choice is inaccurate, as the procedure targets pancreatic head tumors, not generalized malignancies like lung or breast cancer.

Choice C reason: Bowel obstruction is typically managed with procedures like adhesiolysis or resection, not a Whipple procedure, which involves removing the pancreatic head, duodenum, and bile duct. Obstructions are unrelated to pancreatic pathology, making this an inappropriate indication for this complex surgical intervention.

Choice D reason: The Whipple procedure (pancreaticoduodenectomy) is primarily performed for pancreatic cancer, especially in the pancreatic head. It removes the tumor, part of the pancreas, duodenum, and bile duct to treat localized malignancy, aiming for curative resection, making this the correct indication for the surgery.

Choice A reason: A high-protein diet supports tissue repair but is not the priority in chronic pancreatitis. Excessive protein can increase pancreatic enzyme demand, potentially exacerbating inflammation, as the pancreas struggles to produce sufficient enzymes, making this less critical than fat restriction for symptom control.

Choice B reason: A low-fat diet is essential in chronic pancreatitis to minimize pancreatic stimulation. Dietary fat triggers cholecystokinin release, stimulating pancreatic enzyme secretion, which can worsen inflammation and pain in a damaged pancreas, making this the priority to reduce exacerbations and promote comfort.

Choice C reason: A high-carbohydrate diet provides energy but may increase glucose levels, complicating diabetes, a common pancreatitis complication. It does not address pancreatic inflammation or enzyme secretion, making it less critical than a low-fat diet for managing chronic pancreatitis symptoms effectively.

Choice D reason: A low-sodium diet prevents fluid retention in conditions like heart failure but is not primary in chronic pancreatitis. While fluid balance is important, sodium restriction does not directly reduce pancreatic inflammation or pain, making it less relevant than fat restriction in this condition.