An adult patient is admitted with AIDS and oral Candida albicans manifested by several painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive personnel (UAP) and discusses how to assist the patient.

Which instruction should the nurse give to the UAP?

Choice A rationale:

Wild rice is naturally gluten-free. It is not a grain, but rather a semi-aquatic grass seed. It is safe for individuals with celiac disease to consume.

Wild rice is a good source of nutrients. It is high in fiber, protein, and antioxidants, and it contains a variety of vitamins and minerals, including manganese, phosphorus, magnesium, and zinc. These nutrients can help to support overall health and well-being.

Wild rice can be a versatile ingredient in many dishes. It can be used in salads, soups, stews, pilafs, and even desserts.

Choice B rationale:

Oatmeal is not gluten-free. It is made from oats, which are a type of cereal grain that contains gluten. Individuals with celiac disease must avoid gluten, as it can trigger an autoimmune reaction that damages the small intestine.

Even small amounts of gluten can cause harm. Consuming even a small amount of oatmeal can cause symptoms such as abdominal pain, bloating, diarrhea, fatigue, and headache in individuals with celiac disease.

Long-term damage can occur. If individuals with celiac disease continue to consume gluten, it can lead to long-term health problems, such as malnutrition, osteoporosis, and infertility.

Choice C rationale:

Corn chips are typically gluten-free. However, it is important to check the label to be sure, as some brands may contain gluten- containing ingredients, such as wheat flour or barley malt.

Reading labels is essential. Individuals with celiac disease should always read food labels carefully to ensure that products are gluten-free.

Choice D rationale:

Potatoes are naturally gluten-free. They are a safe and healthy food choice for individuals with celiac disease.

Potatoes are a versatile and nutritious food. They are a good source of carbohydrates, fiber, potassium, vitamin C, and other nutrients.

Choice A rationale:

Amber urine can be a sign of dehydration, but it is not specific to cholelithiasis with a gallstone lodged in the common bile duct.

While it's important to monitor hydration status in patients with nausea and vomiting, amber urine alone would not be the most urgent finding to report to the healthcare provider in this context.

Choice B rationale:

Belching is a common symptom of gastrointestinal disorders, but it is not specific to cholelithiasis with a gallstone obstruction. It can be caused by various factors, such as swallowing air, eating too quickly, or drinking carbonated beverages.

While belching might be a symptom the nurse documents, it would not be the most concerning finding to report immediately.

Choice C rationale:

Flatulence is another common gastrointestinal symptom that can have various causes, including dietary choices, bacterial fermentation in the intestines, and certain medications.

It is not specific to cholelithiasis with a gallstone obstruction and would not be the most relevant finding to prioritize reporting.

Choice D rationale:

Yellow sclera, also known as jaundice, is a significant finding that strongly suggests cholestasis, which is the obstruction of bile flow.

Bile, a fluid produced by the liver, aids in digestion and gives stool its brownish color.

When bile flow is obstructed, as in the case of a gallstone lodged in the common bile duct, bilirubin (a component of bile) builds up in the bloodstream and tissues, leading to yellowing of the skin and sclera (the whites of the eyes).

This is a crucial finding to report to the healthcare provider because it indicates a worsening of the patient's condition and the need for prompt intervention to address the obstruction.