A nurse is providing anticipatory guidance to a client who has phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?
"Diet sodas should not be consumed more than two or three times per week."
"A low-protein diet should be followed for 3 months prior to conception."
"Serum bilirubin should be monitored one to two times per month during pregnancy."
"Breastfeeding will prevent your baby from developing PKU."
The Correct Answer is B
Phenylketonuria (PKU) is an inherited metabolic disorder in which the body cannot properly process an amino acid called phenylalanine. If left untreated, phenylalanine can build up to harmful levels in the body, leading to intellectual disability and other health problems. Managing PKU involves following a strict low-phenylalanine diet.
When discussing anticipatory guidance for a client with PKU who is planning a pregnancy, it is important to focus on monitoring the maternal phenylalanine levels during pregnancy. Serum bilirubin is not directly related to PKU management and would not require specific monitoring in this context.
Regarding the other options:
"Diet sodas should not be consumed more than two or three times per week": While it is generally advisable to limit the consumption of diet sodas due to their artificial sweeteners, this statement does not directly relate to PKU management or pregnancy planning.
"A low-protein diet should be followed for 3 months prior to conception": A low-protein diet is a fundamental aspect of managing PKU. However, the timeline mentioned (3 months prior to conception) is not supported by current guidelines. PKU management should be ongoing and tailored to the individual's needs, with dietary adjustments made as necessary throughout pregnancy.
"Breastfeeding will prevent your baby from developing PKU": This statement is incorrect. Breast milk naturally contains phenylalanine, which could be harmful to an infant with PKU. Infants with PKU must receive a specialized formula that is low in phenylalanine from birth. Breastfeeding is not recommended for infants with PKU unless specifically guided by a healthcare professional.

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Related Questions
Correct Answer is C
Explanation
The instruction that the nurse should include for a client with Parkinson's disease prescribed a monoamine oxidase inhibitor (MAOI) is as follows: "Avoid aged cheeses while taking this medication."
MAOIs are a class of medications used to treat Parkinson's disease by increasing the levels of certain neurotransmitters in the brain. However, they can interact with certain foods and beverages, leading to potentially dangerous side effects.
The interaction between MAOIs and aged cheeses is due to the presence of tyramine, a substance that can cause a sudden and dangerous increase in blood pressure known as a hypertensive crisis. Aged cheeses, such as cheddar, blue cheese, and feta, contain high levels of tyramine, and consuming them while taking an MAOI can lead to this hypertensive crisis.

The other options listed in the question are not directly related to the use of MAOIs in Parkinson's disease:
Eating grapefruit is typically contraindicated with certain medications, but it is not specifically relevant to MAOIs or Parkinson's disease.
Maintaining a low-protein diet is not a standard recommendation for individuals taking MAOIs or Parkinson's disease unless specifically advised by the healthcare provider.
Reducing the intake of high-calorie foods is a general recommendation for overall health and weight management but is not specifically related to the use of MAOIs or Parkinson's disease.
Correct Answer is A
Explanation
In teaching about dietary guidelines to promote cardiovascular health, the nurse should include the recommendation to increase the intake of whole grains. Whole grains, such as whole wheat, brown rice, oats, and quinoa, are rich in fiber, vitamins, minerals, and phytochemicals that are beneficial for cardiovascular health. They can help lower cholesterol levels, improve blood sugar control, and reduce the risk of heart disease.
The other choices are incorrect:
Increasing the intake of refined carbohydrates is not a recommended recommendation for promoting cardiovascular health. Refined carbohydrates, such as white bread, white rice, and sugary snacks, have been associated with an increased risk of heart disease. They are often low in fiber and can cause spikes in blood sugar levels, leading to poor cardiovascular health outcomes.
Decreasing the intake of potassium is also not a recommended recommendation. Potassium is an essential mineral that plays a vital role in maintaining heart health and blood pressure regulation. Adequate intake of potassium-rich foods, such as bananas, avocados, spinach, and sweet potatoes, can help lower blood pressure and reduce the risk of cardiovascular diseases.
Decreasing intake of omega-3 fatty acids is incorrect as well. Omega-3 fatty acids, found in fatty fish (such as salmon, mackerel, and sardines), flaxseeds, chia seeds, and walnuts, have been shown to have numerous cardiovascular benefits. They can help reduce inflammation, lower triglyceride levels, improve heart rhythm, and decrease the risk of heart disease. Therefore, it is important to include omega-3 fatty acids in the diet for optimal cardiovascular health.
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