A nurse is caring for a client who is starting treatment for substance use disorder. Which of the following actions indicates the nurse is practicing the ethical principle of nonmaleficence?

A. Identify the goals that the client achieved during the relationship:
This activity typically occurs during the termination or closure phase of the nurse-client relationship. It involves reflecting on the progress made by the client toward their goals. During this phase, both the nurse and the client review the goals set at the beginning of the therapeutic relationship and identify which ones have been achieved. This helps in evaluating the effectiveness of the therapeutic interventions.

B. Assist the client to make changes in her behavior:
This action is a central aspect of the working phase. In this phase, the nurse and client collaboratively work on addressing the client's issues. The nurse provides support, guidance, and appropriate interventions to help the client modify their thoughts, emotions, and behaviors. The goal is to facilitate positive changes and promote the client's mental and emotional well-being.

C. Inform the client about confidentiality issues:
Discussing confidentiality is essential at the beginning of the therapeutic relationship, during the orientation phase. The nurse informs the client about the limits of confidentiality, explaining what information will be kept confidential and under what circumstances confidentiality might need to be breached (such as when there is a risk of harm to the client or others). This discussion helps establish trust and clear boundaries within the relationship.

D. Discuss the client's responsibilities for the relationship:
Clarifying the client's responsibilities occurs primarily during the orientation phase. In this phase, the nurse outlines what the client can expect from the therapeutic relationship and what is expected from them. This includes discussing the client's active participation in the process, their commitment to attending sessions, being open and honest, and actively engaging in therapeutic activities and homework assignments.

A. Pseudoephedrine
Clients taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) used to treat depression, need to avoid certain over-the-counter medications, especially those containing sympathomimetic amines like pseudoephedrine. Combining MAOIs with sympathomimetic medications can lead to a severe increase in blood pressure, potentially causing a hypertensive crisis.

B. Docusate sodium:
Docusate sodium is a stool softener and is generally safe to use with phenelzine. It does not have significant interactions with MAOIs.

C. Ranitidine:
Ranitidine is an H2 blocker used to reduce stomach acid production. It does not have significant interactions with phenelzine.

D. Ibuprofen:
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation. While it does not interact directly with phenelzine, individuals taking phenelzine should avoid other medications, especially NSAIDs, that can increase the risk of bleeding due to phenelzine's effects on platelet function. However, this interaction is not as severe as the interaction between phenelzine and sympathomimetic medications like pseudoephedrine.