The nurse provides education to a client who is newly diagnosed with multiple sclerosis (MS). Which client statements indicate the need for additional teaching? SELECT ALL THAT APPLY

Choice A: Reviewing communicable disease statistics. This is incorrect because this is an example of descriptive epidemiology, not analytic epidemiology. Descriptive epidemiology describes the distribution and patterns of health events in populations, such as the frequency, location, and time of occurrence.

Choice B: Tracking locations where family violence is increasing. This is incorrect because this is also an example of descriptive epidemiology, not analytic epidemiology. Descriptive epidemiology tracks the trends and variations of health problems in different groups or areas.

Choice C: Describing population characteristics for healthy older citizens. This is incorrect because this is another example of descriptive epidemiology, not analytic epidemiology. Descriptive epidemiology provides information about the demographic and social factors that influence health outcomes.

Choice D: Identifying factors contributing to childhood obesity. This is correct because this is an example of analytic epidemiology. Analytic epidemiology investigates the causes and associations of health events in populations, such as the risk factors, exposures, or interventions that affect health outcomes. Analytic epidemiology often uses comparison groups to test hypotheses and draw conclusions.

Choice A reason: Planning medication doses to occur before meals is a good suggestion to improve the client's nutritional status. Myasthenia gravis is a neuromuscular disorder that causes weakness and fatigue of the voluntary muscles, especially those involved in chewing and swallowing. Taking anticholinesterase medications before meals can enhance muscle strength and coordination, and make it easier for the client to eat and avoid choking or aspiration.

Choice B reason: Restricting drinking fluids before and during meals is not a good suggestion to improve the client's nutritional status. Fluid intake is important for hydration and digestion, and should not be limited unless there is a medical reason, such as fluid overload or heart failure. Drinking fluids before and during meals can also help lubricate the food and prevent dryness or irritation of the mouth and throat.

Choice C reason: Increasing the amount of fat and carbohydrates in meals is not a good suggestion to improve the client's nutritional status. Fat and carbohydrates are sources of energy, but they can also increase the risk of obesity, diabetes, or cardiovascular disease if consumed excessively. A balanced diet that includes adequate protein, vitamins, minerals, and fiber is more beneficial for the client's health and well-being.

Choice D reason: Eating three large meals per day is not a good suggestion to improve the client's nutritional status. Eating large meals can be difficult and exhausting for the client with myasthenia gravis, as their muscle strength and endurance may decline over time. Eating smaller and more frequent meals can help maintain the energy level and prevent fatigue or hunger.