A nurse is reinforcing dietary teaching with a client who has a new prescription for a monoamine oxidase Inhibitor (MAOI). Which of the following foods should the nurse instruct the client to avoid while taking an MAOI?

The correct answer is choice A and D.

Choice A rationale:

Establishing rapport with the client is a fundamental nursing action to create a trusting relationship, which is especially important when a client is experiencing acute anxiety. A strong rapport can help the client feel more secure and supported, making it easier to manage their anxiety.

Choice B rationale:

Making eye contact is generally considered a non-threatening and effective way to communicate care and attention. Avoiding eye contact could make the client feel isolated or ignored. Therefore, this is not a recommended action when attending to a client with acute anxiety.

Choice C rationale:

Using a high-pitched voice can be perceived as alarming or stressful, which may exacerbate the client’s anxiety. It is important to use a calm, soothing tone when speaking to someone who is anxious.

Choice D rationale:

Validating the client’s feelings and identifying the cause of the anxiety are therapeutic techniques that acknowledge the client’s experience and can help in addressing the underlying issues contributing to the anxiety. This can be a crucial step in helping the client to cope with and overcome their anxiety.

Choice A rationale:

Hemoglobin (Hgb) of 11 g/dL is slightly below the normal range for adult females (12-16 g/dL) but is not considered a critical value.

It may indicate mild anemia, which is common in bulimia nervosa due to factors such as poor nutrition and blood loss from self-induced vomiting. However, it would not typically be the most urgent finding requiring immediate intervention.

Choice B rationale:

Potassium of 2.8 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and is considered a critical value, indicating severe hypokalemia.

Hypokalemia is a potentially life-threatening electrolyte imbalance that can lead to cardiac arrhythmias, muscle weakness, respiratory failure, and even death.

It is a common complication of bulimia nervosa due to excessive vomiting and/or laxative abuse, which can lead to significant potassium loss.

Therefore, this finding would be the nurse's priority, necessitating immediate intervention to correct the hypokalemia and prevent potentially life-threatening complications.

Choice C rationale:

Serum chloride of 96 mEq/L is slightly below the normal range (98-106 mEq/L) but is not considered a critical value.

It may be associated with hypokalemia, as chloride and potassium are often lost together in conditions like bulimia nervosa.

However, it would not typically be the most urgent finding requiring immediate intervention.

Choice D rationale:

Serum amylase of 240 units/L is elevated above the normal range (30-110 units/L) but is not considered a critical value.

It may indicate inflammation of the pancreas (pancreatitis), which can be a complication of bulimia nervosa due to recurrent vomiting and/or alcohol abuse.

However, it would not typically be the most urgent finding requiring immediate intervention, especially in comparison to severe hypokalemia.