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A nurse is reviewing a food diary with a client who has depression.

Which of the following client food choices should the nurse identify as interacting with the client's prescribed medication?

Select all that apply.

Smoked turkey

Strawberries

Yogurt

1% milk

Tomatoes

Lettuce

Swiss cheese

Avocados

Answer and Explanation

Correct Answer : A,G,H

A. Smoked turkey: Smoked, cured, or processed meats contain high levels of tyramine, which can interact with MAOIs like isocarboxazid, potentially causing a hypertensive crisis. Clients on MAOIs must avoid foods high in tyramine to prevent dangerous blood pressure spikes.

B. Strawberries: Fresh strawberries are low in tyramine and generally safe for clients taking MAOIs. They do not pose a significant risk of interaction with isocarboxazid.

C. Yogurt: Plain yogurt contains only minimal tyramine and is typically considered safe in moderation. It does not usually precipitate hypertensive reactions with MAOIs unless it is aged or fermented.

D. 1% milk: Milk is low in tyramine and does not interact significantly with MAOIs. It is generally considered safe for consumption while on isocarboxazid.

E. Tomatoes: Fresh tomatoes have low tyramine content and are safe for clients on MAOIs. Only aged or processed tomato products (e.g., sauces, paste) pose a risk.

F. Lettuce: Lettuce contains negligible tyramine and does not interact with MAOI therapy, making it safe for the client to consume.

G. Swiss cheese: Aged cheeses like Swiss contain high levels of tyramine, which can interact with isocarboxazid and increase the risk of hypertensive crisis. Clients on MAOIs should avoid all aged cheeses.

H. Avocados: Overripe avocados contain significant tyramine and can trigger hypertensive reactions in clients taking MAOIs. Only unripe or fresh avocados are considered safer, but caution is generally advised.

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Correct Answer is B

Explanation

A. Sympathize with the client's situation: Expressing sympathy may seem supportive, but it can reinforce the client’s negative outlook rather than promote exploration of feelings or problem-solving. It may also shift focus away from objective assessment of the client’s emotional state.

B. Observe the client's nonverbal behaviors: Nonverbal cues such as facial expressions, posture, and gestures provide important information about the client’s emotional state and level of distress. Observing these behaviors helps the nurse assess mood, affect, and potential risk factors while planning appropriate interventions.

C. Remind the client that they will feel better in a few days: Offering reassurance without first understanding the client’s feelings can minimize their experience and may reduce trust. Immediate reassurance is less therapeutic than assessing and validating the client’s current emotional state.

D. Ignore the client's negative response and leave the room: Ignoring the client’s expression of distress is inappropriate and can damage rapport. It prevents the nurse from gathering essential information needed for emotional support and intervention planning.

A. The client talks excessively. B. The client dresses in vivid, bright colors. C. The client refuses to eat. D. The client sleeps 6 hr at night.

Correct Answer is C

Explanation

A. The client talks excessively: Pressured speech is a common manifestation of mania in bipolar disorder. While it requires monitoring, it does not pose an immediate threat to the client’s health.

B. The client dresses in vivid, bright colors: Wearing bright or unusual clothing reflects the euphoric or expansive mood seen in mania. This behavior is not immediately harmful and does not take priority over basic physiological needs.

C. The client refuses to eat: Refusal to eat can lead to malnutrition, dehydration, and electrolyte imbalances, which are life-threatening if not addressed promptly. Maintaining adequate nutrition and hydration is a priority over behavioral or mood-related symptoms.

D. The client sleeps 6 hr at night: Reduced sleep is common during manic episodes but is not immediately life-threatening. Sleep deprivation should be monitored, but the client’s refusal to eat requires more urgent intervention.

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A nurse is reviewing a food diary with a client who has depression. Which of the following client food choices should the nurse identify as interacting with the client's prescribed medication?

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A nurse is reviewing a food diary with a client who has depression.

Which of the following client food choices should the nurse identify as interacting with the client's prescribed medication?