A client who is obese reports severe pain and inability to bear weight in the right knee after making dietary changes 3 weeks ago for weight loss. The client's medical history includes hypertension, gouty arthritis, and cholecystitis. Which instruction should the nurse include in the discharge teaching?
Use electric heating pad when pain is at its worse.
Increase fluid intake to 2000 mL per day.
Exercise daily for at least 30 minutes.
Eat high protein foods to achieve ideal body weight.
The Correct Answer is B
A. Use electric heating pad when pain is at its worse: Heat can help relieve stiffness in arthritis, but during acute gout flares, applying heat may exacerbate inflammation. Cold therapy is generally recommended during severe joint pain episodes.
B. Increase fluid intake to 2000 mL per day: Adequate hydration helps prevent uric acid crystal formation, which can reduce the frequency and severity of gout attacks. Encouraging increased fluid intake is an important part of long-term management in clients with gouty arthritis.
C. Exercise daily for at least 30 minutes: While regular exercise supports weight loss and overall joint health, exercising during an acute flare can worsen pain and potentially injure the affected joint. Activity should be resumed gradually once inflammation subsides.
D. Eat high protein foods to achieve ideal body weight: High-protein diets, especially those rich in purines (e.g., red meat, organ meats), can exacerbate gout. Discharge teaching should focus on balanced nutrition with attention to foods that minimize uric acid levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
A. Continue PROM if joint's muscle spasms to relax muscle: Continuing to move a joint during muscle spasms can worsen injury or cause pain. PROM should be stopped if spasms occur and reassessed to prevent harm.
B. Slowly stretch the joint's muscles if pain is present: Stretching a joint when pain is present can cause tissue damage or exacerbate injury. Pain indicates that the joint has reached its limit, so exercises should be within a pain-free range.
C. Move the joint slowly until resistance is felt: Moving the joint slowly until resistance allows for safe assessment of mobility and flexibility without overstretching or causing injury. Resistance provides a natural limit to the joint’s passive range of motion.
D. Instruct the client to relax during the exercises: Relaxation reduces muscle tension, allowing for safer and more effective passive movements. Client cooperation helps prevent muscle guarding and ensures proper joint mobilization.
E. Support the extremity of the joint being exercised: Supporting the extremity prevents undue stress on muscles and joints, reduces the risk of injury, and allows controlled movement during PROM exercises. Proper support is essential for safety.
Correct Answer is A,C,B,D
Explanation
A. Obtain blood glucose level: The first step is to check the client’s blood glucose so the correct insulin dose can be determined according to the sliding scale prescription. Without this value, safe and accurate dosing cannot be achieved.
B. Draw insulin into insulin syringe: After verifying the prescription, the correct amount of insulin is drawn up. This ensures accuracy and avoids delays once the injection site has been prepared, maintaining sterility and efficiency.
C. Verify the insulin prescription: Before drawing up the insulin, the nurse or client must compare the blood glucose result with the sliding scale prescription to determine the exact dose required. This prevents medication errors and ensures correct administration.
D. Cleanse the selected site: The last step before injection is cleansing the skin with an alcohol swab. This minimizes infection risk and prepares the area for insulin administration after the correct dose has been measured.
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