A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid?

Choice A reason: Using a Snellen chart to assess visual acuity is not a direct measure of the effectiveness of pilocarpine, which is used to lower intraocular pressure by constricting the pupil and increasing aqueous humor outflow. Visual acuity may be affected by other factors, such as refractive errors, cataracts, or macular degeneration.

Choice B reason: Checking the amount of drainage from each eye is not a relevant action for evaluating the effectiveness of pilocarpine, which does not affect tear production or drainage. Excessive or abnormal eye drainage may indicate an infection, allergy, or injury.

Choice C reason: Palpating the eyelids for decreased swelling is not a useful action for evaluating the effectiveness of pilocarpine, which does not cause or reduce eyelid swelling. Eyelid swelling may be caused by inflammation, infection, allergy, or trauma.

Choice D reason: Reviewing eye pressure measurements is the correct action for evaluating the effectiveness of pilocarpine, which is used to lower intraocular pressure in patients with open-angle glaucoma. High intraocular pressure can damage the optic nerve and cause vision loss. Pilocarpine reduces intraocular pressure by constricting the pupil and increasing aqueous humor outflow.

Choice A reason: Beef tips with gravy are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Beef tips with gravy do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice B reason: Deep-fried shrimp are not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Deep-fried shrimp do not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.

Choice C reason: Pepperoni pizza is a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pepperoni pizza contains tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis. Tyramine is found in aged, fermented, cured, smoked, or pickled foods, such as cheese, salami, sauerkraut, soy sauce, beer, and wine.

Choice D reason: Pan-seared catfish is not a dietary choice that should be avoided by a client taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) that treats depression. Pan-seared catfish does not contain tyramine, which is a substance that can interact with MAOIs and cause a hypertensive crisis.