A nurse is teaching a patient who has osteoarthritis.Which of the following instructions should the nurse include in the teaching?

Choice A rationaleAcetaminophen is often recommended as a first-line analgesic for managing mild to moderate pain associated with osteoarthritis. It acts centrally to inhibit prostaglandin synthesis in the central nervous system and block pain impulses peripherally. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen lacks significant anti-inflammatory properties and does not typically cause gastrointestinal irritation or bleeding, making it a safer initial option for chronic pain management in many individuals.Choice B rationaleDecreasing foods high in purines is a dietary recommendation for patients with gout, a type of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints. Osteoarthritis, however, is a degenerative joint disease resulting from cartilage breakdown and is not directly linked to purine metabolism or uric acid levels. Therefore, this dietary modification is not relevant to managing osteoarthritis.Choice C rationaleWhile elevating an affected joint can help reduce swelling and discomfort, it is generally recommended for acute inflammation or injury rather than the chronic pain of osteoarthritis. Large pillows under the knee or hip for extended periods can actually promote joint flexion contractures and should be avoided. Proper positioning usually involves maintaining joint alignment and avoiding prolonged static positions.Choice D rationaleApplying heat can provide pain relief and muscle relaxation for osteoarthritis by increasing blood flow to the area and reducing stiffness. However, the temperature should be comfortably warm, not below body temperature, to achieve these therapeutic effects. Heat application typically ranges from 104°F to 113°F (40°C to 45°C) for optimal benefit without causing burns.