A nurse is teaching the partner of a client about administering intermittent enteral feedings. Which of the following instructions should the nurse include?

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.

Choice A reason: Hypernatremia is not a sign of water intoxication, but rather the opposite condition. Hypernatremia means high sodium levels in the blood, which can occur when the body loses more water than sodium, such as in dehydration, diabetes insipidus, or excessive salt intake. Water intoxication causes hyponatremia, which means low sodium levels in the blood, due to excessive water intake or retention.

Choice B reason: Weak pulses are not a specific sign of water intoxication, but rather a general sign of poor perfusion or circulation. Weak pulses can have many causes, such as hypotension, shock, heart failure, or peripheral vascular disease. Water intoxication can cause hypotension, but it can also cause hypertension, depending on the volume status of the client.

Choice C reason: Muscle weakness is a sign of water intoxication, as it reflects the effect of low sodium levels on the neuromuscular system. Sodium is essential for nerve and muscle function, as it helps generate electrical impulses and contractions. When sodium levels drop too low, the nerves and muscles become less responsive and weaker. Other signs of water intoxication affecting the nervous system include confusion, headache, seizures, and coma.

Choice D reason: Exaggerated reflexes are not a sign of water intoxication, but rather a sign of hyperreflexia, which is a condition of overactive reflexes. Hyperreflexia can have many causes, such as spinal cord injury, stroke, multiple sclerosis, or electrolyte imbalance. Water intoxication can cause electrolyte imbalance, but it usually leads to hyporeflexia, which is a condition of reduced or absent reflexes.