The nurse is educating a client newly diagnosed with gout regarding dietary choices. The nurse understands that further teaching is needed if the client orders which foods for lunch?

  1. fruit cup with corn bread and tea
  2. tuna fish sandwich with green peas
  3. a peanut butter sandwich with 1 percent milk
  4. low-fat cheese and crackers with blueberries
Number 2 is correct.
Rationale: Tuna, along with sardines, scallops, and organ meats, is high in purine and should be avoided by clients with gout. Green peas are a medium-purine food and should be limited to a half cup per day. Low-purine foods include fruit and fruit juices, corn bread, pasta, bread, nuts, and peanut butter. Tea, 1 percent or skim milk, low-fat cheese, and low-fat ice cream are suitable diet choices on a low-purine diet.