A nurse is providing follow-up care with a client who participated in a class about improving bone health. Which of the following client statements should the nurse identify as an understanding of the teaching?

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: Sipping fluids slowly throughout the day can help prevent dehydration and electrolyte imbalance, which can worsen nausea and vomiting. Fluids also help flush out the toxins from the chemotherapy and reduce the risk of kidney damage¹².

Choice B reason: Consuming foods that are served cold can help reduce the stimulation of the chemoreceptor trigger zone (CTZ), which is responsible for triggering nausea and vomiting. Cold foods also have less odor and taste, which can be unpleasant for some clients with CINV³⁴.

Choice C reason: Sitting up for 1 hr after eating meals can help prevent reflux and aspiration, which can cause more nausea and vomiting. Sitting up can also promote gastric emptying and digestion.

Choice D reason: Limiting the use of antiemetics until after the first emesis is not a recommended practice, as it can make nausea and vomiting more difficult to control. Antiemetics should be given before, during, and after chemotherapy, according to the emetogenic potential of the agents and the client's individual response.

Choice E reason: Eating foods low in carbohydrates is not a helpful strategy for CINV, as carbohydrates can provide energy and prevent hypoglycemia, which can also cause nausea and vomiting. Carbohydrates can also help settle the stomach and reduce acid production.