A nurse is teaching a client who has a goiter appropriate food choices related to dietary needs. Which of the following client statements indicates an understanding of the teaching?

Choice A reason: Elastic skin turgor is a sign of adequate hydration and fluid balance. Skin turgor is the ability of the skin to return to its normal shape after being pinched or pulled. When the skin is dehydrated, it loses its elasticity and becomes tented or wrinkled. The nurse should assess the skin turgor on the chest, abdomen, or forehead, and not on the hands or feet, which can be affected by aging or edema.

Choice B reason: Dry mucous membranes are a sign of fluid volume deficit, not fluid volume excess. Mucous membranes are the moist linings of the mouth, nose, eyes, and other body openings. When the body is dehydrated, the mucous membranes become dry, cracked, or sticky. The nurse should assess the mucous membranes for color, moisture, and capillary refill.

Choice C reason: Oliguria is a sign of fluid volume deficit, not fluid volume excess. Oliguria is the production of abnormally small amounts of urine, usually less than 400 mL per day or 30 mL per hour. Oliguria can indicate reduced kidney function, impaired blood flow to the kidneys, or inadequate fluid intake. The nurse should monitor the urine output, color, specific gravity, and presence of blood or protein.

Choice D reason: Tachycardia is a sign of fluid volume deficit, not fluid volume excess. Tachycardia is a rapid heart rate, usually more than 100 beats per minute. Tachycardia can occur when the body is dehydrated, as the heart tries to pump more blood to maintain the blood pressure and perfusion. The nurse should measure the pulse rate, rhythm, quality, and amplitude.

Choice A reason: Crohn's disease is not commonly associated with obesity, although obesity can worsen the symptoms and complications of Crohn's disease. Crohn's disease is a type of inflammatory bowel disease that causes inflammation and ulcers in the digestive tract, especially the small intestine and colon. The exact cause of Crohn's disease is unknown, but it may involve genetic, immune, and environmental factors.

Choice B reason: Celiac disease is not commonly associated with obesity, although obesity can make the diagnosis of celiac disease more difficult. Celiac disease is an autoimmune disorder that causes damage to the small intestine when gluten, a protein found in wheat, barley, and rye, is ingested. The damage interferes with the absorption of nutrients and can lead to malnutrition, anemia, and osteoporosis.

Choice C reason: Peptic ulcer disease is not commonly associated with obesity, although obesity can increase the risk of complications from peptic ulcer disease. Peptic ulcer disease is a condition that causes sores or ulcers in the lining of the stomach or duodenum, the first part of the small intestine. The most common causes of peptic ulcer disease are infection with Helicobacter pylori bacteria and use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Choice D reason: Gastroesophageal reflux disease (GERD) is commonly associated with obesity, as obesity can increase the pressure on the lower esophageal sphincter (LES), the muscle that prevents the backflow of stomach acid into the esophagus. GERD is a condition that causes heartburn, regurgitation, chest pain, and difficulty swallowing due to the reflux of stomach acid into the esophagus. GERD can also lead to esophagitis, Barrett's esophagus, and esophageal cancer.