A client diagnosed with glaucoma receives a new prescription for dorzolamide. Prior to administering the medication, the nurse should review the electronic medical record for which allergy?

A. Sugar cookies: Sugar cookies are low in fat and not highly acidic, making them less likely to trigger reflux. This choice demonstrates understanding of dietary restrictions because it avoids common GERD triggers such as high-fat, spicy, or acidic foods.

B. Pizza: Pizza is high in fat, contains tomato sauce, and often includes spices—all of which can increase gastric acid secretion and exacerbate reflux symptoms. This food is not an appropriate choice for a child with GERD.

C. Tacos: Tacos typically contain seasoned meat, spices, and fatty ingredients that are known to aggravate reflux. The combination of fat and spice makes them unsuitable for someone managing GERD symptoms.

D. Chocolate milkshake: Chocolate and high-fat dairy products can lower esophageal sphincter tone and delay gastric emptying, both of which contribute to worsening reflux. This makes it an inappropriate snack option.

Rationale:

• Instruct incentive spirometry use every hour: Indicated to promote lung expansion and prevent complications such as pneumonia or atelectasis. Even though the infection is in the leg, maintaining adequate oxygenation and pulmonary function is critical in older adults with multiple comorbidities.

• Use petroleum-based lotion on skin: Contraindicated because petroleum-based products can trap moisture and bacteria, increasing the risk of worsening cellulitis or skin breakdown. Non-occlusive, water-based moisturizers are safer for diabetic or infected skin.

• Administer antibiotics: Indicated as the client has a bacterial infection (cellulitis) with erythema, warmth, swelling, and elevated WBC count. IV cefazolin is prescribed to treat the infection promptly and prevent progression to sepsis.

• Suggest that client ambulate often: Contraindicated because the affected leg is inflamed, painful, and at risk for injury or worsening edema. Early ambulation may exacerbate discomfort and impair healing; activity should be gradual and guided by pain tolerance and clinical stability.

• Encourage consumption of protein and vitamin C: Indicated to support wound healing and immune function. Adequate protein and vitamin C intake are essential for tissue repair and recovery from infection, particularly in older adults with chronic comorbidities.

• Apply thromboembolism deterrent stockings (TED): Indicated to prevent venous thromboembolism, especially since the client has limited mobility due to pain and swelling, advanced age, and comorbid conditions like heart failure and diabetes.