A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond?
Explain that the need to restrict fluids is the primary limitation.
Advise the client to limit foods that are high in calcium and iron.
Describe the use of an elimination diet to find trigger foods.
Instruct the client to avoid foods with gluten, such as wheat bread.
The Correct Answer is C
Rationale:
A. While some clients may need to manage fluid intake based on their symptoms, it is not the primary dietary restriction for Crohn's disease.
B. Clients with Crohn's disease often need to focus on nutrient-rich foods; limiting calcium and iron is not generally advised unless specific deficiencies are present.
C. An elimination diet can help identify trigger foods that exacerbate symptoms, making this response appropriate and beneficial for managing Crohn's disease.
D. Avoiding gluten is specifically related to celiac disease rather than Crohn's disease, as not all individuals with Crohn's need to eliminate gluten unless they have an associated gluten sensitivity.
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Correct Answer is B
Explanation
Rationale:
A. Sodium levels are important for fluid balance but are not directly related to the symptoms of fatigue and pallor in this context.
B. Hemoglobin is crucial to assess in this situation because the client’s fatigue and pallor may indicate anemia, which could be a side effect of long-term diclofenac use and is common in clients with rheumatoid arthritis.
C. Glucose levels are essential for metabolic health but are not relevant to the client's current symptoms.
D. Total protein levels can provide information on nutritional status and liver function, but they are not the most immediate concern given the client's presentation.
Correct Answer is B
Explanation
Rationale:
A. While working as a construction worker may involve exposure to various pathogens, it is not as critical as the client's history of substance use.
B. A reported history of alcoholism is significant because terbinafine is metabolized by the liver, and a history of alcohol use could affect liver function, increasing the risk of liver toxicity. This finding requires further assessment before administration.
C. Thick and yellow toenails indicate a fungal infection, which is the reason for the terbinafine prescription but does not impact the immediate safety of administering the medication.
D. A white blood cell count of 8,500/mm³ is within the normal range and does not indicate an immediate concern related to medication administration.