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Patient Data

Exhibits

The nurse is reviewing the client's dietary choices for opportunities to promote better outcomes by limiting gout attacks. Select the 3 dietary choices that are not part of the recommended diet for a client with gout.

Sardines

Oatmeal

Chicken

Garlic

Oranges

Shrimp

Quinoa

Lentils

Liver

Spinach

Answer and Explanation

Correct Answer : A,F,I

Rationale for Correct Choices:

Sardines: Sardines are high in purines, which are metabolized into uric acid. High purine intake can precipitate gout attacks by increasing serum uric acid levels and worsening inflammation in joints.
Shrimp: Shellfish, including shrimp, contain moderate to high levels of purines. Regular consumption can trigger gout flares, making them unsuitable for clients managing hyperuricemia.
Liver: Organ meats like liver are extremely high in purines, significantly increasing uric acid production. Eating liver can exacerbate gout attacks and interfere with long-term uric acid control.

Rationale for Incorrect Choices:

Oatmeal: Oatmeal is a low-to-moderate purine food, generally safe for clients with gout when eaten in moderation. It does not significantly increase uric acid levels.
Chicken: Lean chicken is moderate in purines, but when consumed in appropriate portions, it is considered acceptable for a gout diet. It does not carry the same risk as organ meats or seafood.
Garlic: Garlic has negligible purine content and may even have anti-inflammatory properties. It is safe and can be included in a gout-friendly diet.
Oranges: Citrus fruits like oranges are low in purines and rich in vitamin C, which may help reduce uric acid levels and are safe for gout management.
Quinoa: Quinoa is a plant-based protein that is low in purines and suitable for clients managing gout. It does not significantly affect uric acid levels.
Lentils: Lentils contain moderate purines but are plant-based and considered safe in moderation for gout management. They provide beneficial nutrients without significantly raising uric acid.
Spinach: Spinach is slightly higher in purines but generally not enough to trigger gout attacks when consumed as part of a balanced diet. It is considered safe in moderate amounts.

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Correct Answer is A

Explanation

Rationale:
A. "I will avoid sitting and crossing my legs.": Avoiding prolonged sitting and refraining from crossing the legs helps prevent venous stasis and promotes proper blood return from the lower extremities, which is essential in managing chronic venous insufficiency.

B. “I will lift weights every other day.": Strenuous weight lifting increases intra-abdominal and venous pressure, which can exacerbate venous insufficiency and is not recommended as routine home care.

C. "I will be able to stand as long as my legs do not hurt.": Prolonged standing can worsen venous pooling and edema, even if discomfort is not immediately felt.

D. "I will need to get someone to walk my dog.": While walking can promote circulation, delegating all walking is unnecessary. Moderate, regular ambulation is encouraged for venous return rather than complete avoidance of activity.

A. Alteration in nutrition related to poor dietary intake. B. Alteration in comfort related to motor vehicle collision. C. Anxiety related to unknown outcome of automobile repairs. D. High risk for injury related to increased intracranial pressure.

Correct Answer is D

Explanation

Rationale:
A. Alteration in nutrition related to poor dietary intake: Inadequate nutrition is important to address, especially given the client’s financial concerns, but it is not immediately life-threatening compared to potential neurological complications.

B. Alteration in comfort related to motor vehicle collision: Headache, blurred vision, vertigo, and nausea may affect comfort, but prioritizing comfort alone overlooks potential serious complications from a recent head injury.

C. Anxiety related to unknown outcome of automobile repairs: Financial or situational anxiety is present, but it does not pose an immediate threat to physical health and is lower priority compared to neurological assessment.

D. High risk for injury related to increased intracranial pressure: The combination of neuro symptoms and three weeks post-collision suggests a possible post-concussion syndrome or delayed intracranial complication. Prompt assessment and monitoring for increased intracranial pressure are the priority to prevent serious neurological injury.

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Patient Data Exhibits The nurse is reviewing the client's dietary choices for opportunities to promote better outcomes by limiting gout attacks. Select the 3 dietary choices that are not part of the recommended diet for a client with gout.

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Patient Data

Exhibits

The nurse is reviewing the client's dietary choices for opportunities to promote better outcomes by limiting gout attacks. Select the 3 dietary choices that are not part of the recommended diet for a client with gout.