A nurse is caring for a client who is receiving continuous enteral nutrition and is experiencing diarrhea. Which of the following actions should the nurse take?

Choice A reason: Fried chicken is an acceptable choice for a client who is taking tranylcypromine, a monoamine oxidase inhibitor (MAOI). MAOIs can cause a hypertensive crisis if the client consumes foods that are high in tyramine, such as aged cheeses, cured meats, smoked fish, and fermented products. Fried chicken does not contain tyramine and is safe to eat.

Choice B reason: Salami is not an acceptable choice for a client who is taking tranylcypromine, as it is a cured meat that is high in tyramine. The nurse should advise the client to avoid salami and other similar foods, such as pepperoni, ham, bacon, and sausage.

Choice C reason: Smoked salmon is not an acceptable choice for a client who is taking tranylcypromine, as it is a smoked fish that is high in tyramine. The nurse should advise the client to avoid smoked salmon and other similar foods, such as herring, anchovies, and caviar.

Choice D reason: Cheddar cheese is not an acceptable choice for a client who is taking tranylcypromine, as it is an aged cheese that is high in tyramine. The nurse should advise the client to avoid cheddar cheese and other similar foods, such as blue cheese, Swiss cheese, and Parmesan cheese.

Choice A reason: Acute stress causes an increase in metabolism, as the body activates the sympathetic nervous system and releases hormones such as adrenaline and cortisol. These hormones increase the heart rate, blood pressure, and oxygen consumption, and mobilize glucose and fatty acids for energy. The nurse should explain to the clients that acute stress can have beneficial effects, such as enhancing alertness, memory, and performance, but it can also have harmful effects, such as impairing digestion, immunity, and growth.

Choice B reason: Stress causes a negative nitrogen balance in the body, not a positive one. Nitrogen balance is the difference between the amount of nitrogen ingested and the amount of nitrogen excreted. A positive nitrogen balance means that the body is retaining more nitrogen than it is losing, which indicates growth, healing, or pregnancy. A negative nitrogen balance means that the body is losing more nitrogen than it is retaining, which indicates malnutrition, illness, or injury. The nurse should inform the clients that stress can cause a negative nitrogen balance, as the body breaks down protein for energy and loses nitrogen through urine, sweat, and wounds.

Choice C reason: Protein requirements increase in times of stress, not decrease. Protein is essential for tissue repair, immune function, and hormone synthesis. The nurse should advise the clients that stress can increase the protein needs of the body, as the body loses protein through catabolism, inflammation, and infection. The nurse should recommend the clients to consume adequate amounts of high-quality protein, such as eggs, milk, cheese, meat, fish, poultry, soy, and nuts.

Choice D reason: Glucose is broken down more quickly during times of stress, not more slowly. Glucose is the main source of energy for the brain and the muscles. The nurse should educate the clients that stress can increase the glucose levels in the blood, as the body releases glucose from the liver and muscles to provide fuel for the stress response. The nurse should also warn the clients that chronic stress can lead to insulin resistance, diabetes, and cardiovascular disease.