The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders (Select All that Apply.)

A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.

B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.

C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.

D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.

A) Decreased bowel sounds:
While diarrhea can lead to changes in bowel function, such as increased frequency and urgency, it typically does not cause decreased bowel sounds. In fact, hyperactive bowel sounds may be present in some cases of diarrhea due to increased gastrointestinal motility and peristalsis as the body attempts to expel excess stool.

B) Dehydration:
This is the correct answer. Diarrhea can result in fluid and electrolyte losses, leading to dehydration if not adequately managed. Common symptoms of dehydration include increased thirst, dry mucous membranes, decreased urine output, dark urine, fatigue, weakness, and dizziness. In severe cases, dehydration can lead to hypovolemic shock, a life-threatening condition requiring immediate medical attention.

C) Rigid abdomen:
While abdominal discomfort and cramping are common symptoms of diarrhea, a rigid abdomen is not typically associated with uncomplicated cases of diarrhea. However, severe abdominal pain, distention, and rigidity may indicate underlying complications such as bowel obstruction or peritonitis, which require urgent medical evaluation.

D) Hypothermia:
Hypothermia, or abnormally low body temperature, is not a typical finding in clients with diarrhea. In fact, diarrhea is more commonly associated with fluid and electrolyte imbalances that can lead to hyperthermia (elevated body temperature) due to dehydration and inflammatory responses. However, hypothermia may occur in severe cases of dehydration or sepsis, but it is not a direct consequence of diarrhea itself.