A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

Beef tips with gravy.

Deep-fried shrimp.

Pepperoni pizza.

Pan-seared catfish.

Answer and Explanation

The Correct Answer is C

Choice A reason: Beef tips with gravy are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Beef tips with gravy do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice B reason: Deep-fried shrimp are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Deep-fried shrimp do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice C reason: Pepperoni pizza is a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pepperoni pizza contains tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis. Tyramine is found in aged, fermented, cured, smoked, or pickled foods, such as cheese, salami, sauerkraut, soy sauce, beer, and wine.

Choice D reason: Pan-seared catfish is not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pan-seared catfish does not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

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Correct Answer is C

Explanation

Choice A reason: Obtaining a hospital bed with side rails and an over-bed trapeze is not a necessary instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. A hospital bed may be helpful for patients with severe mobility impairment or bedridden status, but not for all patients with Parkinson's disease.

Choice B reason: Placing small rugs on smooth surfaces such as tile or wood floors is an incorrect instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. Small rugs can pose a tripping hazard and increase the risk of falls, especially for patients with impaired balance or coordination.

Choice C reason: Using caution when changing from a sitting to a standing position is a correct instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. Carbidopa-levodopa can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can cause dizziness, fainting, or falls. Patients should change positions slowly and carefully, and use support if needed.

Choice D reason: Ambulating using a four point cane or a walker with wheels is not a specific instruction for reducing the risk of injury for a client taking carbidopa-levodopa, which is a combination of two drugs that increase dopamine levels in the brain and improve motor function in patients with Parkinson's disease. The type of assistive device that is appropriate for each patient depends on their individual needs and abilities. Some patients may not need any device, while others may need different types of canes, walkers, or wheelchairs.

Correct Answer is []

Explanation

Potential Condition:Methemoglobinemia

Methemoglobinemia is a condition in which the hemoglobin in the blood is unable to bind oxygen effectively, resulting in tissue hypoxia. It can be caused by exposure to certain drugs or chemicals, such as nitrates, benzocaine, or dapsone. Some symptoms of methemoglobinemia include cyanosis, headache, fatigue, dyspnea, and tachycardia. In severe cases, it can lead to seizures, coma, and death.

Actions to Take:

Draw blood for a complete blood count
administer methylene blue

A complete blood count (CBC) can help diagnose methemoglobinemia by measuring the level of methemoglobin in the blood. A normal level is less than 1%, while a level above 15% can cause symptoms. A level above 30% can be life-threatening. Methylene blue is a medication that can reduce methemoglobin back to normal hemoglobin and restore oxygen delivery to the tissues. It is given intravenously at a dose of 1-2 mg/kg over 5 minutes.

Parameters to Monitor:

Methemoglobin level
heart rate and rhythm

The methemoglobin level is the most important parameter to monitor in methemoglobinemia, as it indicates the severity of the condition and the response to treatment. The goal is to lower the level below 10% or until symptoms resolve. The heart rate and rhythm are also important to monitor, as methemoglobinemia can cause tachycardia and dysrhythmias due to hypoxia and acidosis. The goal is to maintain a normal sinus rhythm and a heart rate within the normal range for the client’s age and condition.

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A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

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Naxlex Comprehensive Predictor Exams

A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa, a dopaminergic drug. To reduce the client's risk for injury, which instruction should the nurse provide?

Correct Answer is C

Explanation

Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

Correct Answer is []

Explanation

A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline?

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