A nurse is providing teaching about food choices to a client who has a new prescription for tranylcypromine. Which of the following foods should the nurse identify as an acceptable choice while the client is taking this medication?

Choice A reason: Hypernatremia is not a sign of water intoxication, but rather the opposite condition. Hypernatremia means high sodium levels in the blood, which can occur when the body loses more water than sodium, such as in dehydration, diabetes insipidus, or excessive salt intake. Water intoxication causes hyponatremia, which means low sodium levels in the blood, due to excessive water intake or retention.

Choice B reason: Weak pulses are not a specific sign of water intoxication, but rather a general sign of poor perfusion or circulation. Weak pulses can have many causes, such as hypotension, shock, heart failure, or peripheral vascular disease. Water intoxication can cause hypotension, but it can also cause hypertension, depending on the volume status of the client.

Choice C reason: Muscle weakness is a sign of water intoxication, as it reflects the effect of low sodium levels on the neuromuscular system. Sodium is essential for nerve and muscle function, as it helps generate electrical impulses and contractions. When sodium levels drop too low, the nerves and muscles become less responsive and weaker. Other signs of water intoxication affecting the nervous system include confusion, headache, seizures, and coma.

Choice D reason: Exaggerated reflexes are not a sign of water intoxication, but rather a sign of hyperreflexia, which is a condition of overactive reflexes. Hyperreflexia can have many causes, such as spinal cord injury, stroke, multiple sclerosis, or electrolyte imbalance. Water intoxication can cause electrolyte imbalance, but it usually leads to hyporeflexia, which is a condition of reduced or absent reflexes.

Choice A reason: Drinking orange juice with iron supplements can increase absorption, not decrease it. Orange juice is rich in vitamin C, which enhances the absorption of non-heme iron, the type of iron found in plant foods and supplements. The nurse should advise the client to take iron supplements with a source of vitamin C, such as orange juice, strawberries, or tomatoes.

Choice B reason: Cooking in a stainless steel skillet does not increase the amount of iron in the food. Stainless steel is not a good conductor of iron and does not leach iron into the food. The nurse should suggest the client to use a cast iron skillet instead, which can add iron to the food, especially acidic foods like tomatoes or citrus fruits.

Choice C reason: Drinking iced tea with meals can decrease the amount of iron absorbed, not increase it. Iced tea contains tannins, which are compounds that bind to iron and inhibit its absorption. The nurse should recommend the client to avoid drinking tea, coffee, or other beverages that contain tannins with meals, and to drink them between meals instead.

Choice D reason: Fish and poultry are primary sources of heme iron, which is the type of iron found in animal foods and is more easily absorbed by the body. The nurse should encourage the client to eat more foods that are high in heme iron, such as fish, poultry, meat, and eggs.