A nurse is teaching a class about safe medication administration. The nurse should include in the teaching that which of the following references are acceptable for safe medication administration? (Select all that apply.)

A. "Do not drink alcohol while taking this medication": Disulfiram is a medication used to deter alcohol consumption by producing unpleasant effects, such as nausea, vomiting, and flushing, if alcohol is consumed. Therefore, it is crucial for the client to abstain from alcohol while taking disulfiram to avoid these adverse reactions.

B. "Do not crush this medication before swallowing": While it is generally important not to alter the formulation of medications unless instructed by a healthcare provider or indicated in the medication's instructions, crushing disulfiram is not typically a concern. However, the primary focus of disulfiram therapy is the avoidance of alcohol, rather than specific administration instructions.

C. "Avoid grapefruit juice while taking this medication": Grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, there is no significant interaction between disulfiram and grapefruit juice. Therefore, this information is not relevant to disulfiram therapy.

D. "Take this medication with food": Disulfiram is typically taken on an empty stomach, as food can interfere with its absorption. Therefore, advising the client to take disulfiram with food is not accurate and may compromise its effectiveness. The primary concern with disulfiram therapy is adherence to abstinence from alcohol.

A. Akathisia: Akathisia is characterized by restlessness and an inability to sit still. While it can be a side effect of antipsychotic medications like haloperidol, it does not present with fever, hypertension, and muscle rigidity, as described in the scenario.

B. Neuroleptic malignant syndrome (NMS): NMS is a potentially life-threatening condition associated with antipsychotic medications like haloperidol. It is characterized by hyperthermia, autonomic dysfunction (e.g., hypertension), altered mental status, and severe muscle rigidity. The client's symptoms of fever, elevated blood pressure, and muscle rigidity are consistent with NMS.

C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and other body parts. It is a long-term side effect of antipsychotic medications and typically develops after prolonged use, unlike the acute onset seen in the scenario.

D. Agranulocytosis: Agranulocytosis is a rare but serious side effect of antipsychotic medications, characterized by a severe reduction in white blood cell count, leading to an increased risk of infection. The symptoms described in the scenario are not consistent with agranulocytosis.