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Ketorolac: Ketorolac is a potent nonsteroidal anti-inflammatory drug (NSAID) often used for severe pain. However, it can cause gastrointestinal irritation and bleeding, which poses a significant risk for a client with a history of peptic ulcers. Therefore, administering ketorolac would not be advisable in this situation.

Aspirin: Aspirin is another NSAID that can increase the risk of gastrointestinal bleeding, especially in individuals with a history of peptic ulcers. While it is effective for pain relief, its anticoagulant properties and irritation potential make it an unsuitable choice for this client.

Ibuprofen: Like other NSAIDs, ibuprofen can cause gastrointestinal issues, including irritation and bleeding. Given the client’s history of peptic ulcers, using ibuprofen could lead to exacerbation of the condition and should be avoided in favor of safer alternatives for pain management.

"I should limit my intake of dairy products to prevent nausea.": While some clients may experience nausea, limiting dairy is not typically recommended for managing stomatitis. In fact, dairy can be soothing for some individuals. This statement does not address the specific needs related to stomatitis and indicates a misunderstanding of dietary management during treatment.

"I should gargle with an alcohol-based mouthwash to kill germs.": Alcohol-based mouthwashes can further irritate the mucous membranes and exacerbate stomatitis symptoms. Acknowledging this would demonstrate a lack of understanding, as alcohol is contraindicated in the management of oral mucosal irritation caused by radiation therapy.

"I should moisten my lips with lemon-glycerin swabs.": Lemon-glycerin swabs can actually irritate the mouth and exacerbate discomfort in clients with stomatitis. This approach is not recommended, and selecting such a treatment indicates a misunderstanding of appropriate oral care measures during radiation therapy.

Administer 1 L dextrose 5% in water IV bolus prior to the procedure: Administering a large volume IV bolus is generally unnecessary before a paracentesis. It can lead to abdominal distension and discomfort, potentially complicating the procedure. Fluid management should be carefully considered based on the client’s condition rather than a standard bolus.

Initiate NPO status 4 hr prior to the procedure: Paracentesis typically does not require NPO status unless sedation is planned, which is uncommon. Keeping the client NPO can cause unnecessary discomfort and does not align with standard pre-procedural care for a paracentesis, which usually allows for regular oral intake.

Position the client over an overbed table prior to the procedure: While positioning is crucial for comfort and access, clients are generally positioned sitting at the edge of the bed or in a semi-Fowler's position. An overbed table may not provide adequate support and could lead to discomfort or complications during the procedure.

Potatoes: Potatoes are generally safe to consume while taking an MAOI. They do not contain significant amounts of tyramine, which is the substance that can interact dangerously with MAO inhibitors. Thus, they are not contraindicated.

Grapefruit: While grapefruit can interact with various medications by affecting liver enzymes, it is not specifically contraindicated with MAOIs. The main concern with MAOIs relates to tyramine-containing foods rather than grapefruit.

Eggs: Eggs are considered safe for consumption with MAOIs, as they do not contain tyramine. They do not pose the same risk as high-tyramine foods and can be included in the diet without concern for interactions.

Edema: While edema can occur in some patients, it is not a common or serious side effect of simvastatin. Clients should monitor for any unusual swelling, but it is not the primary concern associated with this medication.

Weight loss: Weight loss is not typically associated with simvastatin use. Clients should be aware of their weight but reporting weight loss alone is not usually necessary unless it is significant or accompanied by other concerning symptoms.

Fever: Fever is not a typical side effect of simvastatin. While clients should report any signs of infection or unusual symptoms, fever alone is not specifically linked to the use of this medication and does not warrant immediate concern related to simvastatin therapy.

Assist the client in expressing alternative behaviors: This action is more appropriate for later phases of the therapeutic relationship. During the orientation phase, the focus is on establishing rapport and trust rather than implementing behavioral changes.

Facilitate the client's problem-solving skills: While enhancing problem-solving skills is important in therapy, it typically occurs in later phases after trust and rapport have been established. The orientation phase is primarily about getting to know the client and their needs.

Determine previous coping skills used by the client: Understanding past coping mechanisms is valuable, but this exploration is more suitable for subsequent phases of the relationship. The orientation phase focuses on initial assessments and building a connection, rather than diving into the client's history of coping strategies.

Encourage the client to spend time in the dayroom: While social interaction can be beneficial, a client experiencing mania may become overstimulated in a busy environment. This intervention may not be appropriate if it increases anxiety or agitation.

Place the client in seclusion when he exhibits signs of anxiety: Seclusion should be a last resort and is not an appropriate first-line intervention. Instead, the focus should be on therapeutic approaches that promote safety and reduce anxiety without resorting to restrictive measures.

Withdraw the client's TV privileges if he does not attend group therapy: Using punitive measures such as withdrawing privileges is not therapeutic and can exacerbate feelings of rejection or frustration. A supportive approach is more effective in encouraging participation in therapy rather than implementing consequences.

Suspicious of others: Suspiciousness is more characteristic of paranoid personality disorder. While individuals with narcissistic personality disorder may have difficulties in relationships, they are not typically driven by suspicion; rather, they may have an inflated sense of self-importance and entitlement.

Exhibits separation anxiety: Separation anxiety is generally not associated with narcissistic personality disorder. Clients with this disorder often exhibit self-sufficiency and may not show signs of dependency that would lead to separation anxiety.

Ritualistic behavior: Ritualistic behaviors are more indicative of obsessive-compulsive disorder or obsessive-compulsive personality disorder. Narcissistic personality disorder is focused on self-importance and seeking admiration rather than engaging in specific rituals or compulsions.

"The client is exceptionally clingy to others.": While individuals with borderline personality disorder may have intense relationships, they are not typically described as "clingy" in the same way as those with dependent personality disorder. Instead, they may exhibit a fear of abandonment that leads to tumultuous relationships.

"The client is overly concerned about minor details.": This behavior is more characteristic of obsessive-compulsive personality disorder rather than borderline personality disorder. Individuals with borderline personality disorder tend to struggle with emotional regulation and relationships rather than focusing on minor details.

"The client might act seductively.": While some individuals with borderline personality disorder may exhibit seductive behavior, it is not a defining characteristic of the disorder. This behavior can be a way to cope with feelings of emptiness or to seek validation, but it is not universally applicable to all clients with borderline personality disorder.

Avoid eye contact with the client: Avoiding eye contact can create a sense of distance and may not promote a therapeutic relationship. Establishing appropriate eye contact can help convey attentiveness and support, even in clients experiencing hallucinations.

Encourage the client to lie down in a quiet room: While a quiet environment can be calming, simply lying down may not effectively address the hallucinations. Active engagement and coping strategies are often needed to help the client manage their symptoms.

Refer to the hallucinations as if they are real: Acknowledging hallucinations as real can reinforce the delusional experience rather than helping the client to cope with or understand their symptoms. It is essential to approach the subject sensitively while maintaining a focus on reality, promoting safety and support.