The nurse is caring for a client with a history of gout. Which dietary recommendation should the nurse emphasize?

Choice A reason: Rinsing the mouth after using a corticosteroid inhaler prevents oral candidiasis, a common side effect from residual steroid deposition. This ensures safe asthma management, as fungal infections compromise adherence and health, making it the priority teaching point for proper inhaler use.

Choice B reason: Using the inhaler only during asthma attacks applies to rescue inhalers, not maintenance corticosteroids, which are used daily. This is incorrect, as rinsing the mouth is essential for corticosteroid inhalers to prevent oral thrush, ensuring safe and effective asthma control.

Choice C reason: Storing inhalers in a refrigerator is unnecessary and may degrade some medications. Room-temperature storage is standard. Rinsing the mouth after corticosteroid inhaler use is critical to prevent oral candidiasis, making it the priority teaching point for asthma management.

Choice D reason: Shaking the inhaler only once may be insufficient for proper aerosolization in some devices. Rinsing the mouth after corticosteroid inhaler use is the priority, as it prevents oral thrush, a significant side effect, ensuring safe and consistent asthma therapy.

Choice A reason: Limiting purine-rich foods (e.g., organ meats, shellfish) reduces uric acid production, preventing gout flares. Purines metabolize into uric acid, which forms joint crystals in gout. This dietary restriction is critical to manage symptoms and prevent painful exacerbations effectively.

Choice B reason: Increasing dairy may reduce gout risk by lowering uric acid, but it is secondary to purine restriction. Limiting purines directly decreases uric acid synthesis, addressing the primary cause of gout flares, making it the priority dietary recommendation.

Choice C reason: Restricting carbohydrates is irrelevant to gout, which results from uric acid accumulation. Purine-rich foods are the primary dietary trigger, as they increase uric acid. Limiting purines is the priority, as it directly prevents crystal formation and gout exacerbations.

Choice D reason: Encouraging red meat, high in purines, worsens gout by increasing uric acid production. Limiting purine-rich foods is critical, as it reduces uric acid and joint crystal formation, making red meat consumption counterproductive to effective gout management.