A nurse is teaching a client about protein. Which of the following foods should the nurse include in the teaching as a complete protein? (Select all that apply)

Choice A reason: Sipping fluids slowly throughout the day can help prevent dehydration and electrolyte imbalance, which can worsen nausea and vomiting. Fluids also help flush out the toxins from the chemotherapy and reduce the risk of kidney damage¹².

Choice B reason: Consuming foods that are served cold can help reduce the stimulation of the chemoreceptor trigger zone (CTZ), which is responsible for triggering nausea and vomiting. Cold foods also have less odor and taste, which can be unpleasant for some clients with CINV³⁴.

Choice C reason: Sitting up for 1 hr after eating meals can help prevent reflux and aspiration, which can cause more nausea and vomiting. Sitting up can also promote gastric emptying and digestion.

Choice D reason: Limiting the use of antiemetics until after the first emesis is not a recommended practice, as it can make nausea and vomiting more difficult to control. Antiemetics should be given before, during, and after chemotherapy, according to the emetogenic potential of the agents and the client's individual response.

Choice E reason: Eating foods low in carbohydrates is not a helpful strategy for CINV, as carbohydrates can provide energy and prevent hypoglycemia, which can also cause nausea and vomiting. Carbohydrates can also help settle the stomach and reduce acid production.

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.