The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

A) Provide information on increasing medication dosage if ketoacidosis occurs: While it is important for clients with diabetes to understand the signs and symptoms of diabetic ketoacidosis (DKA) and how to respond, increasing insulin dosage on their own without healthcare provider guidance could be dangerous. Adjusting insulin dosage should always be done under the direction of a healthcare provider.

B) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin used for basal (background) insulin coverage in clients with diabetes. Teaching the client how to self-administer insulin injections is essential for effective management of diabetes, especially when using long-acting insulin formulations like insulin glargine. Proper injection technique, site rotation, and storage of insulin are important aspects of this teaching.

C) Demonstrate how to select dose based on before meal blood sugar readings: Insulin glargine is typically administered once daily at the same time each day and is not adjusted based on before meal blood sugar readings. Instead, it provides a steady level of insulin over 24 hours to help control blood sugar levels between meals and overnight.

D) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is not used for the treatment of severe hypoglycemia. Instead, it is a long-acting insulin used to maintain basal insulin levels in clients with diabetes. Severe hypoglycemia is treated with fast-acting glucose sources such as oral glucose tablets, gel, or glucagon injections, and the family should be educated on these treatments instead.

A) Deep-fried shrimp: While deep-fried foods are generally high in fat and calories, there is no specific contraindication for clients taking phenelzine to avoid deep-fried shrimp. However, clients with hypertension may benefit from reducing their intake of high-fat foods.

B) Pan-seared catfish: Pan-seared catfish is a relatively lean protein source and does not contain ingredients known to interact with phenelzine. However, clients with hypertension may benefit from limiting their intake of high-sodium foods, such as pan-seared catfish if it is prepared with added salt.

C) Pepperoni pizza: Pepperoni pizza is a high-sodium food due to its processed meat toppings and cheese, and it may contain ingredients that interact with phenelzine. Phenelzine is a monoamine oxidase inhibitor (MAOI), and consuming foods high in tyramine, such as aged or fermented foods like pepperoni, can lead to hypertensive crisis. Therefore, the nurse should instruct the client to avoid pepperoni pizza to prevent potential interactions and exacerbation of hypertension.

D) Beef tips with gravy: While beef tips with gravy may be high in sodium depending on how it is prepared, there is no specific contraindication for clients taking phenelzine to avoid this food. However, clients with hypertension may benefit from choosing lean cuts of beef and limiting their intake of high-sodium gravies.