The home care nurse is preparing to visit a client with a diagnosis of Meniere's disease. The nurse reviews the physician prescription and expects to note that which of the following dietary measures is prescribed?

1. A

   A low-fiber diet with decreased fluid

2. B

   A low-sodium diet and fluid restriction

3. C

   A low-fat diet with a restriction of citrus fruits

4. D

   A low-carbohydrate diet and the elimination of red meats

Appeared in: DHS 2018 shift 1st

Explanation

• Meniere's disease is characterized by endolymphatic hydrops, which is an excess of fluid in the inner ear.
• A low-sodium diet is prescribed to reduce fluid retention throughout the body, which helps to lower the fluid volume and pressure within the inner ear.
• Sodium and fluid retention disrupt the delicate balance between endolymph and perilymph in the inner ear; restricting them helps alleviate symptoms like vertigo and aural fullness.
• This dietary approach is a cornerstone of conservative management for Meniere's disease, often combined with diuretics.

Why Other Options Were Wrong

• Option A: A low-fiber diet has no effect on the fluid balance within the inner ear. It is typically indicated for conditions like acute diverticulitis or before certain bowel procedures.
• Option C: Neither fat intake nor citrus fruits have a direct impact on endolymphatic hydrops. There is no scientific basis for restricting these in Meniere's disease.
• Option D: Carbohydrate and red meat consumption are not related to the pathophysiology of fluid accumulation in the inner ear.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Dietary management of Meniere's disease to guide bedside assessment, documentation, and the next nursing action.
• Patient education is a critical nursing role. The nurse must teach the client how to read food labels to identify and limit high-sodium foods, including processed, canned, and frozen items.
• During home visits, the nurse should assess for signs of fluid overload or dehydration, monitor the patient's weight, and check for adherence to the prescribed diet.
• Safety is paramount. Nurses must educate the client and family on creating a safe home environment to prevent falls and injuries during sudden, unpredictable attacks of vertigo.

How to Approach the Question

• First, identify the core subject of the question: the prescribed diet for Meniere's disease.
• Recall the pathophysiology of Meniere's disease. The key concept is 'endolymphatic hydrops,' which means too much fluid in the inner ear.
• Think logically about how to reduce fluid in the body. The primary dietary method to reduce fluid retention is to limit sodium intake.
• Evaluate the options based on this physiological principle. A low-sodium diet directly addresses the problem of fluid retention.
• Eliminate the other options as they are unrelated to fluid balance in the inner ear. Low-fiber, low-fat, and low-carbohydrate diets target different body systems and conditions.

Concept Tested & Keywords

• Concept Tested: Dietary management of Meniere's disease.
• Stem keywords: home care nurse, Meniere's disease, dietary measures
• Lead-in keywords: which of the following
• Clinical cues: The diagnosis of Meniere's disease is the key clinical cue, which points towards a disorder of fluid balance in the inner ear.

Question ID

QSWGcZNYkPTt3NoRRvBo8A

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 72-74