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?

Choice A reason: Increasing intake of fluids and high protein foods is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that relaxes skeletal muscles and reduces spasticity. Fluids and high protein foods do not affect the action or side effects of baclofen.

Choice B reason: Stopping taking the medication immediately is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that should be tapered off gradually under medical supervision. Abrupt withdrawal of baclofen can cause serious complications, such as seizures, hallucinations, and increased spasticity.

Choice C reason: Obtaining transportation to the emergency department is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that can cause mild and transient side effects, such as fatigue and dizziness. These side effects are not life-threatening and usually subside as the body adjusts to the medication.

Choice D reason: Avoiding hazardous activities until symptoms subside is an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that can impair the ability to drive, operate machinery, or perform other tasks that require alertness and coordination. The client should be advised to exercise caution and avoid activities that could result in injury until they are no longer experiencing fatigue and dizziness.

Choice A reason: Taking a multi-vitamin supplement daily is not a necessary instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. However, some vitamins, such as vitamin K, vitamin E, and vitamin C, can interact with warfarin and affect its effectiveness. Patients should consult their health care provider before taking any supplements or herbal products.

Choice B reason: Using an astringent for superficial bleeding is not a sufficient instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should report any signs of bleeding, such as bruising, nosebleeds, gum bleeding, blood in urine or stool, or prolonged bleeding from cuts or wounds, to their health care provider. They should also avoid activities or products that can increase the risk of bleeding, such as shaving with a razor, using dental floss, or taking aspirin or NSAIDs.

Choice C reason: Adding large amounts of spinach to the diet is an incorrect instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Spinach is a leafy green vegetable that is high in vitamin K, which can counteract the effect of warfarin and increase the risk of clotting. Patients should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

Choice D reason: Avoiding going barefoot, especially outside, is a correct instruction for a client taking warfarin, which is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors and prevents blood clots. Warfarin can increase the risk of bleeding, both internally and externally. Patients should protect their feet from injury or infection by wearing shoes or slippers at all times.