A nurse is providing dietary teaching to a client who has a history of gout and recurring uric acid kidney stones. Which of the following instructions should the nurse include in the teaching?

Restrict calcium intake to one serving per day.

Take 3.000 mg of vitamin C daily.

The nurse should instruct the client to limit foods high in purines.

Eat 12 oz of animal protein daily.

Answer and Explanation

The Correct Answer is C

A. Restrict calcium intake to one serving per day:
This statement is not accurate. Adequate calcium intake is essential for bone health. Calcium-rich foods are important for maintaining strong bones and are not directly related to gout or uric acid kidney stones. It's crucial to differentiate between dietary recommendations for different health conditions.

B. Take 3,000 mg of vitamin C daily:
High doses of vitamin C can increase urinary oxalate and uric acid levels, which might contribute to the formation of kidney stones. It is generally not recommended for individuals with a history of uric acid kidney stones.

C. The nurse should instruct the client to limit foods high in purines.
Dietary changes are important in managing gout and preventing uric acid kidney stones. Purines are natural substances found in many foods, especially animal products, and purine-rich foods can contribute to increased uric acid levels, leading to gout attacks and kidney stones.

D. Eat 12 oz of animal protein daily:
Consuming excessive amounts of animal protein, particularly red meat, can lead to higher purine intake, which is not advisable for individuals prone to gout and uric acid kidney stones. High animal protein intake can increase uric acid production and may exacerbate these conditions. Moderation in protein intake, especially from animal sources, is recommended.

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Correct Answer is A

Explanation

A. "I will reduce my intake of vitamin K-rich foods."
Vitamin K is essential for bone health as it helps in the regulation of calcium within bones and blood vessels. Therefore, reducing the intake of vitamin K-rich foods would not be beneficial for preventing osteoporosis. In fact, adequate intake of vitamin K is important for bone health.

B. "I will limit my intake of soft drinks." - Soft drinks, especially cola beverages, contain phosphoric acid, which can leach calcium from bones, making them weaker and more susceptible to fractures.

C. "I will reduce my intake of sodium." - High sodium intake can lead to increased calcium excretion in the urine, potentially weakening bones over time. Reducing sodium intake can help in preventing bone loss.

D. "I will decrease my intake of caffeine." - Excessive caffeine consumption can interfere with calcium absorption, contributing to bone loss. Decreasing caffeine intake is advisable for maintaining bone health.

A. McBurney's point on the abdomen B. Psoas sign at the knee C. Rovsing's Sign on the abdomen D. costovertebral angle (CVA) on the back

Correct Answer is D

Explanation

A. McBurney's point on the abdomen: McBurney's point is a location in the right lower quadrant of the abdomen that is significant in the assessment for appendicitis. It is not relevant to the assessment of pyelonephritis, which is a kidney infection.

B. Psoas sign at the knee: The psoas sign is a test for appendicitis, not pyelonephritis. It involves the patient lying on their back and lifting their right leg against resistance. If this movement causes pain in the lower right abdomen, it could indicate irritation of the psoas muscle due to an inflamed appendix.

C. Rovsing's Sign on the abdomen: Rovsing's sign is also a test for appendicitis. It involves palpating the left lower quadrant of the abdomen and observing if it causes pain in the right lower quadrant. The presence of pain in the right lower quadrant during palpation of the left lower quadrant can indicate appendicitis. This sign is not specific to pyelonephritis.

D. Costovertebral angle (CVA) on the back: The CVA is located on the back at the angle formed by the 12th rib and the spine. Percussion of the CVA is a common technique used to assess for kidney tenderness. In the case of acute pyelonephritis, infection and inflammation of the kidneys can cause tenderness and pain in the CVA area. Therefore, this area is assessed for pain related to kidney infections like pyelonephritis.

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A nurse is providing dietary teaching to a client who has a history of gout and recurring uric acid kidney stones. Which of the following instructions should the nurse include in the teaching?

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