A nurse is evaluating a client’s understanding of a low-purine diet for gout management.

Which of the following food choices by the client indicates an understanding of the teaching?

Breasts are soft without engorgement or leakage.This indicates that lactation suppression has been successful and the woman is not experiencing any discomfort or risk of infection from milk accumulation.

Breasts are firm with mild tenderness or leakage is wrong because it suggests that lactation is still occurring and the woman may need to express some milk for comfort or use other non-pharmacological methods to suppress it.

Breasts are hard with moderate pain or leakage is wrong because it indicates that the woman is suffering from breast engorgement, which can lead to mastitis if not treated.The woman may need pharmacological intervention to suppress lactation and relieve pain.

Breasts are swollen with severe pain or leakage is wrong because it shows that the woman has developed mastitis, which is a bacterial infection of the breast tissue that requires antibiotics and analgesics.The woman may also need to drain the infected breast by expressing milk or using a pump.

Normal ranges for lactation suppression vary depending on the individual and the method used.Generally, lactation suppression can take from a few days to a few weeks.

Eat small, frequent meals throughout the day.This will help prevent dumping syndrome, which is a condition that occurs when food moves too fast from the stomach to the duodenum, causing symptoms such as abdominal cramps, diarrhea, nausea, vomiting, flushing, dizziness and rapid heart rate.Eating small, frequent meals will reduce the amount of food that enters the small intestine at once and slow down gastric emptying.

Choice B is wrong because drinking fluids with meals rather than between meals will increase the volume of food that enters the small intestine and worsen dumping syndrome symptoms.Fluids should be consumed at least 30 minutes after a meal.

Choice C is wrong because increasing intake of simple carbohydrates such as fruit juice will cause a rapid rise and fall of blood sugar levels, leading to late dumping syndrome symptoms such as sweating, hunger, low blood sugar, fatigue, dizziness and weakness.Simple carbohydrates should be avoided and replaced with complex carbohydrates such as whole grains, fruits and vegetables.

Choice D is wrong because avoiding foods that are high in fat and protein will not help prevent dumping syndrome.In fact, fat and protein can slow down gastric emptying and stabilize blood sugar levels.A moderate amount of fat and protein should be included in each meal.However, too much fat at one time can have the opposite effect and trigger dumping syndrome symptoms.