SN instructed patient to follow a low purine diet to help minimize acute gout attacks by limiting meat, poultry and fish. Animal proteins are high in purine. Avoid or severely limit high-purine foods, such as organ meats, herring, anchovies and mackerel. Red meat (beef, pork and lamb), fatty fish and seafood (tuna, shrimp, lobster and scallops) are associated with increased risk of gout. Because all meat, poultry and fish contain purines, limit your intake to 4 to 6 ounces (113 to 170 grams) daily. SN instructed pt/cg to cut back on fat since saturated fat lowers the body's ability to eliminate uric acid. Also instructed patient Limit or avoid foods sweetened with high-fructose corn syrup. Fructose is the only carbohydrate known to increase uric acid. It is best to avoid beverages sweetened with high-fructose corn syrup, such as soft drinks or juice drinks. Juices that are 100 percent fruit juice do not seem to stimulate uric acid production as much. SN also discussed to choose complex carbohydrates and explained to patient/cg that pt will need to eat more whole grains and fruits and vegetables and fewer refined carbohydrates, such as white bread, cakes and candy. SN advised CG to ensure that pt. drinks plenty of fluids, particularly water. Fluids can help remove uric acid from your body.
Patient was instructed the importance of following a low-sodium, high-potassium diet. Encourage to eat bananas, citrus, fruits.
Instructed patient use sugar in moderation. Consider lower sugar options if available, fruits, vegetables, beans and whole grain foods are good sources of fiber, drink plenty of water, use less salt.
Instructed patient/caregiver on no-added-salt or salt-controlled diet can help control high blood pressure. Even if you are taking medication, it's important to follow a salt-controlled diet to help the medication work more effectively. Use a limited amount of salt in cooking. Don't add salt to your food at the table, either at home or when dining out. Most restaurants add salt when preparing food. Use fresh or dried herbs, spices, and lemon juice to season foods. Avoid ham, bacon, salt pork, and cheese, because these are made with salt. Patient/caregiver verbalized understanding.
Avoiding foods that are rich in fat/cholesterol. Choose only lean meat and avoid the fat. Eat more fish and poultry. Have baked/broiled red meats, fish or poultry instead of fried. Use low-fat or fat-free milk. Try fat-free or low fat cottage cheese or yogurt in place of cream and sour cream. Have steamed vegetables. Dress salads with lemon juice, fat free mayonnaise or fat free dressing.
Instructed patient that when eating out, he/she should order only the foods that are needed, and choose salads with reduced calories dressings, diet drinks and sugar substitutes, etc.
Instructed in limit to three eggs per week.
Instructed patient that he/she may not have to give up eating a slice of cake, but will have to eat a little less bread or potato at the next meal.
Instructed patient to discuss the use of vitamins, minerals or herbal supplements with a doctor since they may interact with diabetic medication.
Instructed patient about the importance of preventing dehydration when sick. This could be avoided drinking non-calorie liquids such as water and diet soft drinks in addition to the normal diet.