A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching?

Choice A is incorrect: Caffeine can worsen sleep disturbances, a common symptom of fibromyalgia.
Choice B is incorrect: While duloxetine is a medication used to manage fibromyalgia symptoms, taking it at a specific time for increased energy is not directly related to understanding the disease itself.
Choice C is incorrect: Fibromyalgia is a chronic condition with no cure. Chemotherapy is not indicated for its treatment.

Choice D is correct: Low-impact aerobics like walking, swimming, or yoga are recommended non-pharmacological interventions for fibromyalgia. They can improve cardiovascular health, flexibility, and pain management.
Additional notes:
Other non-pharmacological management strategies for fibromyalgia include stress management techniques, cognitive behavioral therapy, and adequate sleep hygiene.
Early and comprehensive management of fibromyalgia can significantly improve quality of life.

Choice A rationale:
Restricting weight-bearing on the affected foot may provide some temporary relief from pain during an acute gout attack. However, it is not a long-term management strategy and can lead to muscle weakness and joint stiffness. It's important to gradually resume weight-bearing activities as tolerated to maintain joint function.

Choice B rationale:
Adequate fluid intake is essential for overall health and can help to flush out uric acid from the body. However, 8 liters per day is an excessive amount of fluid and could lead to electrolyte imbalances and other health problems. A more appropriate recommendation for a client with gout would be to aim for a fluid intake of 2-3 liters per day, unless otherwise advised by a healthcare provider.

Choice C rationale:
Restricting consumption of foods high in purines is a key management strategy for gout. Purines are substances found in certain foods that break down into uric acid in the body. High levels of uric acid can lead to the formation of urate crystals, which deposit in joints and cause inflammation and pain. Examples of foods high in purines include organ meats, red meat, seafood, and some types of beans and lentils.

Choice D rationale:
Calcium supplements have not been shown to be effective in the management of gout. In fact, some studies have suggested that calcium supplements may even increase the risk of gout attacks.