A nurse is providing discharge education to a patient who recently experienced an acute gout attack. Which patient statement indicates they have understood the treatment plan?

Choice A rationale

While a 25-year-old planning to lose 20 pounds after childbirth may have increased nutritional needs, they would not typically be considered at higher risk for malnutrition unless there were other factors such as inadequate diet or certain health conditions.
Choice B rationale
A 65-year-old who recently underwent hernia surgery might have temporary changes in diet or appetite related to the surgery, but would not typically be at high risk for malnutrition unless there were other ongoing issues such as poor diet, difficulty eating, or a chronic health condition.
Choice C rationale
A 70-year-old who has been fasting since midnight in preparation for a colonoscopy would not typically be at risk for malnutrition from this short-term fast. However, if they had ongoing issues with diet, appetite, or a chronic health condition, they could potentially be at risk.
Choice D rationale
A 55-year-old who has been consuming alcohol for 35 years is at higher risk for malnutrition. Alcohol can interfere with the body’s ability to absorb and use nutrients, and individuals with long-term heavy alcohol use may also have other lifestyle factors that increase their risk for malnutrition.

Choice A rationale
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.

Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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