A nurse is collecting data from a client who is taking enoxaparin.
The client reports starting the use of dietary supplements.
The nurse should report the use of which of the following supplements to the provider?

Choice A rationale

Instructing the client to tilt their head back increases the risk of aspiration by misaligning the airway and esophagus. Clients with dysphagia require strategies that minimize the risk of aspiration and promote safe swallowing, such as a neutral head position or chin tuck.

Choice B rationale

Scheduling physical therapy directly before meals is inappropriate as it may cause fatigue, reducing the client’s ability to eat safely. Proper scheduling ensures clients have sufficient energy to focus on eating, essential for minimizing aspiration risks in those with dysphagia.

Choice C rationale

Providing oral care before meals reduces the bacterial load in the oral cavity, lowering the risk of aspiration pneumonia if food or liquids are accidentally aspirated. Maintaining good oral hygiene is a key preventive measure for complications related to dysphagia.

Choice D rationale

Encouraging the use of a straw is contraindicated as it can increase the risk of aspiration. Using a straw can direct liquids forcefully to the throat, overwhelming the client’s ability to control swallowing, which is a safety concern for individuals with dysphagia.

Choice A rationale

Camin is not administered via the Z-track method. This technique is primarily used for certain intramuscular injections that may cause irritation or discoloration if they leak into subcutaneous tissues, which is unrelated to Camin's administration.

Choice B rationale

Folic acid is a water-soluble vitamin typically given orally or intravenously. It does not require the Z-track method, as it does not irritate or stain tissues when administered by other intramuscular techniques.

Choice C rationale

Epoetin alfa is usually administered subcutaneously or intravenously. It does not require the Z-track method, as it is not associated with the risks of tissue irritation or permanent staining.

Choice D rationale

Iron dextran is administered using the Z-track method to prevent irritation, pain, and permanent staining of subcutaneous tissues. The method creates a Z-shaped track in the tissue, sealing off the medication and minimizing leakage.