A nurse is assessing a client who has a wound that is not healing. Which of the following dietary supplements should the nurse recommend?

Choice B reason: Older adults should decrease their calorie intake as their metabolic rate and physical activity tend to decline with age. Excess calories can lead to weight gain and increase the risk of chronic diseases such as diabetes, cardiovascular disease, and some cancers. Older adults should aim for a balanced diet that meets their nutritional needs without exceeding their energy requirements.

Choice A reason: Older adults should not decrease their vitamin D intake, as vitamin D is essential for bone health and immune function. Older adults are at risk of vitamin D deficiency due to reduced sun exposure, decreased skin synthesis, and impaired absorption. Vitamin D deficiency can cause osteoporosis, fractures, muscle weakness, and infections. Older adults should consume adequate amounts of vitamin D from fortified foods, supplements, or sun exposure.

Choice C reason: Older adults should not decrease their protein intake, as protein is important for maintaining muscle mass, strength, and function. Older adults are prone to sarcopenia, which is the loss of muscle mass and quality due to aging. Sarcopenia can impair mobility, balance, and independence. Older adults should consume enough protein from animal or plant sources to prevent or delay sarcopenia.

Choice D reason: Older adults should not decrease their fiber intake, as fiber is beneficial for digestive health and blood glucose control. Older adults often suffer from constipation, diverticular disease, and diabetes, which can be alleviated by increasing fiber intake. Fiber can also lower cholesterol levels and reduce the risk of heart disease and some cancers. Older adults should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, legumes, nuts, and seeds.

Choice A reason: Strawberry yogurt is an appropriate food choice for a client who is taking phenelzine, as it does not contain tyramine, a substance that can interact with the medication and cause a hypertensive crisis. Yogurt is also a good source of protein, calcium, and probiotics, which can benefit the client's mood and health.

Choice B reason: Cheddar cheese is not an appropriate food choice for a client who is taking phenelzine, as it contains a high amount of tyramine, especially if it is aged or processed. Cheese and other dairy products that are high in tyramine should be avoided by the client, as they can cause severe hypertension, headache, nausea, and palpitations.

Choice C reason: Smoked salmon is not an appropriate food choice for a client who is taking phenelzine, as it contains a moderate amount of tyramine, especially if it is cured or fermented. Salmon and other fish or meat products that are high in tyramine should be limited or avoided by the client, as they can increase the blood pressure and heart rate.

Choice D reason: Pepperoni pizza is not an appropriate food choice for a client who is taking phenelzine, as it contains a low amount of tyramine, but it can accumulate if consumed in large quantities or with other tyramine-containing foods. Pepperoni and other sausages or deli meats that are high in tyramine should be consumed with caution by the client, as they can cause mild hypertension, flushing, and sweating.