A nurse is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following foods should the nurse advise the client to limit in their diet?

B) Correct. The nurse should obtain a blood sample from the client for a complete blood count as these symptoms can indicate agranulocytosis, a potentially fatal adverse effect of clozapine that causes a severe decrease in white blood cells and increases the risk of infection.

A) Incorrect. The nurse should not administer acetaminophen to the client as this drug can mask the signs of infection and delay diagnosis and treatment of agranulocytosis.

C) Incorrect. The nurse should encourage the client to drink plenty of fluids and rest, but this action alone would not address the potential serious adverse effect of agranulocytosis associated with clozapine. Obtaining a blood sample for a complete blood count is necessary to assess the client's white blood cell count and determine if agranulocytosis is present.

D) Incorrect. Discontinuing clozapine and notifying the provider is important, but it should be done after obtaining a blood sample for a complete blood count to confirm the presence of agranulocytosis. This allows for appropriate medical management and alternative treatment options to be initiated.

B) Correct. The nurse should instruct the client to hold their metformin for 48 hours before and after surgery as this drug can increase the risk of lactic acidosis in clients who are undergoing procedures that involve contrast media or who have impaired renal function due to dehydration or hypotension.

A) Incorrect. The nurse should not instruct the client to take their morning dose of metformin with a sip of water on the day of surgery as this can cause hypoglycemia during anesthesia or interfere with contrast media if used during surgery.

C) Incorrect. The nurse should not instruct the client to resume their metformin as soon as they can tolerate oral intake after surgery as this can cause lactic acidosis if the client's renal function is not fully restored or if they receive contrast media during surgery or postoperatively.

D) Incorrect. The nurse should not instruct the client to switch to insulin injections until they recover from surgery as this can cause hyperglycemia or hypoglycemia depending on the type and dose of insulin used and the client's nutritional status and blood glucose levels.