護理師指導新診斷痛風的病人，應提供哪些飲食衛教？（選所有適合的）
A nurse is teaching a client with newly diagnosed gout. Which dietary instructions should be provided? (Select all that apply.)
- AAvoid high-purine foods such as organ meats✓ 正解避免高普林食物，如動物內臟
- BIncrease intake of alcohol增加酒精攝取量
- CDrink plenty of water to increase uric acid excretion✓ 正解多喝水以增加尿酸排泄
- DLimit consumption of sweetened beverages✓ 正解限制含糖飲料攝取
- EEat large amounts of shellfish daily每天大量食用貝類海鮮
痛風（Gout）是一種代謝性關節炎，其特點是尿酸（uric acid）在體內積聚過多，並沉積在關節及周圍組織，引發發炎反應與劇烈疼痛。核心概念是透過飲食管理來降低體內尿酸水平，減少痛風發作的頻率與嚴重度。 正確答案 A, C, D 是痛風飲食衛教的重點。A 指出應避免高普林（purine）食物，因為普林在體內代謝後會生成尿酸。動物內臟（如肝、腰子）是普林含量最高的食物之一。C 強調補充水分的重要性，充足的水分有助於腎臟排出體內的尿酸，降低尿酸濃度。建議每日飲用 2000-3000 mL 的水分。D 則提醒限制含糖飲料，特別是富含果糖（fructose）的飲料，因為果糖的代謝過程會增加尿酸的生成。酒精（尤其是啤酒）也應限制，因為它會同時增加尿酸生成並抑制尿酸排泄。 選項 B 錯誤，酒精（Alcohol）應限制而非增加攝取。酒精，特別是啤酒，含有較高的普林，並且會干擾尿酸的代謝與排泄，增加痛風發作的風險。選項 E 錯誤，雖然海鮮（shellfish）是蛋白質的良好來源，但許多海鮮，如蝦、貝類、魚卵等，也富含普林，應限制食用，而非鼓勵每日大量攝取。每日攝取過量的海鮮可能導致尿酸升高，誘發痛風。
Gout is a metabolic form of arthritis characterized by excessive accumulation of uric acid in the body, which deposits in joints and surrounding tissues, causing inflammation and severe pain. The core concept is to reduce uric acid levels through dietary management to decrease the frequency and severity of gout attacks. The correct answers - A, C, and D - represent the cornerstones of gout dietary education. A indicates avoiding high-purine foods because purines are metabolized into uric acid; organ meats (such as liver and kidneys) are among the highest-purine foods. C emphasizes the importance of adequate hydration: ample fluid intake helps the kidneys excrete uric acid and lowers its concentration. The recommendation is to drink 2000-3000 mL of fluid daily. D advises limiting sugary beverages, particularly those rich in fructose, because fructose metabolism increases uric acid production. Alcohol (especially beer) should also be limited because it both increases uric acid production and inhibits its excretion. Option B is incorrect; alcohol should be limited rather than increased. Alcohol, especially beer, has a high purine content and interferes with uric acid metabolism and excretion, increasing the risk of gout attacks. Option E is incorrect; although shellfish is a good source of protein, many seafoods such as shrimp, shellfish, and fish roe are also rich in purines and should be limited rather than encouraged daily in large amounts. Excessive daily intake of seafood can raise uric acid levels and trigger gout.