A nurse is providing discharge instructions to a client who has rheumatoid arthritis and a prescription for oral betamethasone. Which of the following statements should the nurse make about how to take this medication?

 

Choice A: Wash raw carrots before cooking

Reason: Washing raw vegetables, including carrots, before cooking is essential to remove dirt, bacteria, and pesticide residues. However, this option is not specific to preventing foodborne illnesses. Washing vegetables is a general hygiene practice, but it does not address the broader aspects of food safety, such as preventing cross-contamination or ensuring proper cooking temperatures. Therefore, while important, it is not the most critical instruction for preventing foodborne illnesses in this context.

Choice B: Separate raw foods from ready-to-eat foods

Reason: Separating raw foods from ready-to-eat foods is crucial to prevent cross-contamination. Raw foods, especially meats, poultry, and seafood, can harbor harmful bacteria that can transfer to ready-to-eat foods if not kept separate. This separation should be maintained during storage, preparation, and cooking. For example, raw meat should be stored on the bottom shelf of the refrigerator to prevent juices from dripping onto other foods. Using separate cutting boards and utensils for raw and ready-to-eat foods further minimizes the risk of cross-contamination.

Choice C: Wash utensils with warm water

Reason: While washing utensils with warm water is a good practice, it is not sufficient on its own to ensure food safety. Utensils that have come into contact with raw meat, poultry, or seafood should be washed with hot, soapy water and sanitized to kill any harmful bacteria. Simply using warm water may not effectively remove or kill bacteria, making this option less critical compared to others that directly address foodborne illness prevention.

Choice D: Practice good hand washing after handling raw eggs, meat, or poultry

Reason: Practicing good hand washing after handling raw eggs, meat, or poultry is one of the most effective ways to prevent foodborne illnesses. Hands can easily transfer bacteria from raw foods to other surfaces, utensils, and foods. Proper hand washing involves scrubbing hands with soap and water for at least 20 seconds, ensuring all parts of the hands are cleaned. This practice helps to eliminate harmful bacteria and reduce the risk of cross-contamination.

Choice E: Ensure all food is cooked to 165°F. Promptly refrigerate foods when finished eating

Reason: Cooking food to the proper internal temperature is essential to kill harmful bacteria that can cause foodborne illnesses. For most foods, an internal temperature of 165°F (73.9°C) is recommended to ensure safety. Using a food thermometer to check the temperature is the best way to ensure food is cooked thoroughly. Additionally, promptly refrigerating foods after eating helps to prevent bacterial growth. Bacteria can multiply rapidly at room temperature, so refrigerating leftovers within two hours (or one hour if the temperature is above 90°F) is crucial for food safety.

Choice A reason: Dependent rubor

Dependent rubor is a reddish discoloration of the skin that occurs when the leg is in a dependent position (hanging down). This condition is typically associated with arterial insufficiency rather than chronic venous insufficiency. Arterial insufficiency occurs when there is inadequate blood flow through the arteries, leading to symptoms such as pain, cramping, and changes in skin color. Dependent rubor is a sign of poor arterial circulation and is not commonly seen in venous insufficiency.

Choice B reason: Thick, deformed toenails

Thick, deformed toenails can be a sign of fungal infections or other conditions affecting the nails, but they are not specifically indicative of chronic venous insufficiency. While individuals with chronic venous insufficiency may have poor circulation that can contribute to nail problems, this symptom is not a primary or common finding associated with the condition. Instead, it is more often related to other underlying health issues.

Choice C reason: Hair loss

Hair loss on the legs can occur due to various reasons, including poor circulation. However, it is more commonly associated with arterial insufficiency rather than chronic venous insufficiency. In arterial insufficiency, the reduced blood flow can lead to hair loss, shiny skin, and other changes in the lower extremities. Chronic venous insufficiency primarily affects the veins and leads to symptoms such as swelling, varicose veins, and skin changes.

Choice D reason: Edema

Edema, or swelling, is a hallmark symptom of chronic venous insufficiency. This condition occurs when the veins in the legs are unable to effectively return blood to the heart, leading to blood pooling in the lower extremities. The increased pressure in the veins causes fluid to leak into the surrounding tissues, resulting in swelling. Edema is often more pronounced at the end of the day or after prolonged periods of standing or sitting. Managing edema is a key aspect of treating chronic venous insufficiency, and it often involves the use of compression stockings, elevation of the legs, and other measures to improve venous return.