The nurse is caring for a group of patients on a medical surgical unit. Which of the following patients is at most risk for developing gout?

The correct answer is A. Exercise.

Choice A: Exercise Exercise is generally beneficial for overall health and is not typically a factor that exacerbates systemic lupus erythematosus (SLE). In fact, regular physical activity can be an important part of the overall treatment plan for individuals with SLE. It can boost energy levels, improve joint flexibility, and help alleviate stress. Therefore, if a patient with SLE identifies exercise as a factor that can exacerbate their condition, it indicates a need for further teaching.

Choice B: Diet Certain diets can potentially trigger or worsen SLE symptoms. For instance, a chemical found in alfalfa may trigger lupus symptoms, so patients may want to avoid eating alfalfa sprouts or taking supplements with alfalfa. Therefore, diet is a correct factor that can exacerbate SLE.

Choice C: Sunlight Exposure to sunlight can trigger or worsen SLE symptoms. For those with lupus, being in the sun can lead to symptoms like skin rashes, itching, burning, joint pain, weakness, and fatigue. In certain cases, it can also result in damage to internal organs. Therefore, sunlight is a correct factor that can exacerbate SLE.

Choice D: Infection Infections can trigger or worsen SLE symptoms. Rates of infections are higher among persons with SLE compared with the general population. Therefore, infection is a correct factor that can exacerbate SLE.

Choice A rationale:
Urine collection from an indwelling catheter is a sterile procedure that requires aseptic technique to prevent contamination of the specimen and potential urinary tract infection. Assistive personnel (AP) may not have the necessary training in sterile technique and therefore should not be delegated this task. Additionally, the nurse needs to assess the patient for any signs of urinary tract infection or other complications before collecting the urine specimen, which is within the scope of nursing practice.

Choice B rationale:
Blood collection for PaCO2 (partial pressure of carbon dioxide) is an invasive procedure that requires assessment of the patient's condition, appropriate site selection, and proper technique to ensure accurate results. This task is within the scope of nursing practice and should not be delegated to AP.

Choice C rationale:
Wound drainage collection for culture also requires aseptic technique to prevent contamination of the specimen and ensure accurate results. The nurse needs to assess the wound for signs of infection, choose the appropriate collection method, and ensure proper labeling and transport of the specimen. This task is within the scope of nursing practice and should not be delegated to AP.

Choice D rationale:
Random stool specimen collection is a non-invasive procedure that does not require sterile technique. AP can be trained to collect random stool specimens safely and effectively, following standard precautions for handling body fluids.