The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving a psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment?

A. Instruct the client to avoid foods with gluten, such as wheat bread.
While some individuals with Crohn's disease may experience improvement by avoiding certain types of carbohydrates, including gluten, this recommendation is not universally applicable to all individuals with Crohn's disease. Gluten restriction is more relevant for those with gluten sensitivity or celiac disease.

B. Explain that the need to restrict fluids is the primary limitation.
This statement is not accurate. Fluid restriction is not a primary dietary limitation for individuals with Crohn's disease. In fact, maintaining adequate hydration is generally important for overall health. Restricting fluids is not a standard dietary recommendation for managing Crohn's disease.

C. Advise the client to limit foods that are high in calcium and iron.
Limiting foods high in calcium and iron is not a standard recommendation for Crohn's disease. In fact, adequate intake of essential nutrients, including calcium and iron, is important for overall health. Limiting these nutrients could lead to nutritional deficiencies.

D. Describe the use of an elimination diet to find trigger foods.
This is the most appropriate response. Crohn's disease symptoms can vary among individuals, and identifying trigger foods through an elimination diet can help personalize dietary recommendations. By systematically eliminating and reintroducing foods, individuals can identify which specific foods may exacerbate their symptoms.

A. Family members can help with regular foot exams:
This is the correct answer. Regular foot exams are essential for individuals with diabetes, especially those with peripheral neuropathy. Family members can assist in identifying any changes, cuts, or wounds on the feet that the client might not be able to perceive due to neuropathy.

B. Heating pads are useful if on the lowest setting:
The use of heating pads is generally not recommended for individuals with peripheral neuropathy. They may have reduced sensation, making it difficult to detect if the pad is too hot, leading to the risk of burns.

C. Aching feet may be soaked in lukewarm water for one hour or more:
Prolonged soaking of feet is not advisable, as it can lead to maceration of the skin and increase the risk of infection. A short, lukewarm foot soak is generally acceptable, but the duration should be limited.

D. Shoes should be worn outside the house, but it is fine to be barefoot inside:
Individuals with diabetes and peripheral neuropathy should wear protective footwear both inside and outside the house to prevent injuries and reduce the risk of complications.