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.
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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Related Questions
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 ["A","D","E"]
Explanation
Choice A reason:
Taking an initial respiratory rate is a necessary action to ensure safety during morphine administration, as morphine can cause respiratory depression, which is a potentially life-threatening side effect. The nurse should monitor the client's respiratory rate and oxygen saturation regularly and report any signs of respiratory distress or hypoxia to the physician. Therefore, choice A is correct.
Choice B reason:
Performing a 12-lead electrocardiogram is not a necessary action to ensure safety during morphine administration, as morphine does not have a significant effect on the cardiac rhythm or conduction. The nurse should monitor the client's heart rate and blood pressure regularly and report any signs of bradycardia, hypotension, or chest pain to the physician. Therefore, choice B is incorrect.
Choice C reason:
Suctioning the client to clear the airway is not a necessary action to ensure safety during morphine administration, as morphine does not cause excessive secretions or bronchospasm that would obstruct the airway. The nurse should assess the client's level of consciousness and gag reflex regularly and report any signs of sedation, confusion, or aspiration to the physician. Therefore, choice C is incorrect.
Choice D reason:
Having a manual resuscitation bag at the bedside is a necessary action to ensure safety during morphine administration, as morphine can cause respiratory depression that may require emergency intervention. The nurse should be prepared to administer oxygen and naloxone (an opioid antagonist) as ordered and perform rescue breathing or cardiopulmonary resuscitation if needed. Therefore, choice D is correct.
Choice E reason:
Asking the client about other medications she takes is a necessary action to ensure safety during morphine administration, as morphine can interact with other drugs that may enhance or reduce its effects or cause adverse reactions. The nurse should review the client's medication history and current medications and report any potential drug interactions or contraindications to the physician. Therefore, choice E is correct.
Choice F reason:
Restraining the client with soft restraints is not a necessary action to ensure safety during morphine administration, as morphine does not cause agitation or delirium that would warrant physical restraint. The nurse should provide a safe and comfortable environment for the client and report any signs of anxiety, hallucinations, or psychosis to the physician. Therefore, choice F is incorrect.
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