Which patients should receive calcium from non-dairy sources?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Edition 3

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Explanation

Lactose intolerance is a condition caused by the deficiency of the enzyme lactase.
Lactase is required to break down lactose, the primary sugar in milk and dairy products.
Without lactase, consuming dairy causes significant gastrointestinal distress, including bloating, gas, and diarrhea.
To avoid these symptoms, individuals with lactose intolerance must avoid dairy products.
Since dairy is a major source of dietary calcium, these patients need to obtain calcium from alternative, non-dairy sources to maintain bone health and prevent conditions like osteoporosis.

Option A: Patients with Phenylketonuria (PKU) restrict protein, including dairy, but their nutritional needs are met with special calcium-fortified formulas. The primary dietary focus is on phenylalanine restriction, not sourcing calcium from general non-dairy foods.
Option C: Patients with osteopenia have low bone density and need to increase their calcium intake. Dairy products are an excellent source of calcium and are generally recommended for these patients.
Option D: Gout management involves restricting high-purine foods to lower uric acid levels. Dairy products are low in purines and are not restricted; some studies suggest low-fat dairy may even be beneficial for gout.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Dietary management for specific health conditions as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating patients with lactose intolerance about their dietary needs, helping them identify and incorporate non-dairy calcium sources to prevent long-term complications like osteoporosis.
It is important to assess for lactose intolerance in patients presenting with gastrointestinal issues or in those with conditions requiring high calcium intake, like osteopenia, to ensure dietary recommendations are appropriate and achievable.
What if? If a patient with osteopenia is also diagnosed with lactose intolerance, the nursing plan would change from recommending dairy to educating the patient on high-calcium, non-dairy foods and potential supplementation to meet their increased calcium needs.

How to Approach the Question

First, understand the core of the question: it asks which condition necessitates avoiding dairy and finding other calcium sources.
Analyze each option by recalling the pathophysiology and standard dietary management for that condition.
For 'Lactose intolerance', recognize this directly involves the inability to digest a component of milk (lactose), making dairy avoidance necessary.
For 'Phenylketonuria', recall the diet restricts an amino acid (phenylalanine), which is in dairy, but the primary solution is a special formula, not just switching to other food sources for calcium.
For 'Osteopenia', identify this as a condition of weak bones needing more calcium, making dairy a recommended food, not one to avoid.
For 'Gout', remember the diet restricts purines, which are not a major component of dairy. This makes the option unrelated to the question's premise.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2194-2196