A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

"I will wear gloves when removing food from the freezer"

"I will take my medications at the first sign of an attack"

"I will try to anticipate and avoid stressful situations when possible"

"I will complete the smoking cessation program I started"

Answer and Explanation

The Correct Answer is B

A. "I will wear gloves when removing food from the freezer": This statement demonstrates understanding of the need to protect the hands from cold exposure, which can trigger Raynaud's disease symptoms. Wearing gloves when handling cold objects, such as food from the freezer, helps minimize the risk of a vasospastic episode.
B. "I will take my medications at the first sign of an attack": This statement indicates a misunderstanding of the appropriate use of medications for Raynaud's disease. While medications such as calcium channel blockers may be prescribed to prevent or reduce the frequency and severity of attacks, they are typically taken regularly as part of ongoing management rather than at the first sign of symptoms. This client may need additional education on the proper use of medications for Raynaud's disease.
C. "I will try to anticipate and avoid stressful situations when possible": Stress can exacerbate symptoms of Raynaud's disease by triggering vasospasm, so anticipating and avoiding stressful situations is a proactive strategy to help prevent attacks. This statement reflects an understanding of the importance of stress management in managing the condition.
D. "I will complete the smoking cessation program I started": Smoking is a significant risk factor for Raynaud's disease and can worsen symptoms by constricting blood vessels. Committing to a smoking cessation program demonstrates the client's recognition of the importance of lifestyle modifications in managing the condition.

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Correct Answer is A

Explanation

A. The client runs 4 miles outdoors every afternoon: Exercise, especially in hot weather, can lead to dehydration and increased sweating, which can result in decreased lithium excretion and increased lithium levels in the blood, leading to toxicity. Therefore, this factor puts the client at risk for lithium toxicity.
B. The client eats 2 to 3 g of sodium-containing foods: Sodium intake can affect lithium levels, as high sodium levels can increase lithium excretion and lower lithium levels. Therefore, eating sodium-containing foods is less likely to contribute to lithium toxicity.
C. The client eats foods high in tyramine: Tyramine-rich foods can interact with certain medications, such as MAOIs, but they do not directly increase the risk of lithium toxicity.
D. The client drinks 2 liters of liquids daily: Adequate hydration is important for clients taking lithium, as dehydration can increase lithium levels. Therefore, drinking 2 liters of liquids daily is not a risk factor for lithium toxicity.

A. "There is no way to predict how long it will last in each individual client B. "It occurs during the first trimester and near the end of the pregnancy." C. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." D. "It’s a minor inconvenience, which you should ignore. "

Correct Answer is B

Explanation

A. "There is no way to predict how long it will last in each individual client." This response acknowledges the variability among individuals but does not provide specific information about urinary frequency during pregnancy. While it's true that the duration of urinary frequency can vary from person to person, the response lacks guidance or reassurance for the client.
B. "It occurs during the first trimester and near the end of the pregnancy." This response correctly identifies the pattern of urinary frequency during pregnancy. Urinary frequency is common during the first trimester due to hormonal changes and the growing uterus pressing on the bladder. It may also occur near the end of pregnancy as the fetus descends into the pelvis, putting pressure on the bladder again.
C. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." This response suggests that urinary frequency typically resolves by the 12th week of pregnancy but may persist if the client has poor bladder tone. While urinary frequency may improve for some women after the first trimester, attributing its continuation solely to poor bladder tone oversimplifies the issue.
D. "It’s a minor inconvenience, which you should ignore." This response minimizes the client's concerns and does not provide helpful information about urinary frequency during pregnancy. Urinary frequency can be distressing for some pregnant individuals and should not be dismissed as a minor inconvenience.

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A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

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A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?