A nurse provides discharge instructions for a patient who is taking acetaminophen [Tylenol] after surgery. The nurse should instruct the patient to avoid which product while taking acetaminophen?

Choice A reason: Captopril PO is used for chronic hypertension, not acute crises, due to slower onset. IV nitroprusside acts rapidly to control severe hypertension, so this is incorrect.

Choice B reason: Hydralazine PO has a slower onset, unsuitable for hypertensive crisis requiring immediate control. IV nitroprusside is faster and titratable, making this incorrect for acute management.

Choice C reason: Minoxidil PO is for refractory hypertension, not emergencies, due to delayed action. Sodium nitroprusside IV is preferred for rapid control, so this is incorrect.

Choice D reason: Sodium nitroprusside IV is the drug of choice for hypertensive crisis, offering rapid, titratable blood pressure reduction. This aligns with urgent needs, making it the correct choice.

Choice A reason: Allergic reactions typically present with symptoms like rash, itching, or anaphylaxis, not jaundice, dark urine, or light stools. These symptoms indicate hepatobiliary dysfunction, not an immune-mediated response. Allergic reactions don’t typically affect liver function or bile excretion, making this choice inconsistent with the patient’s clinical presentation.

Choice B reason: Idiosyncratic drug effects on bone marrow cause hematologic issues like anemia or leukopenia, not jaundice or light stools. These symptoms suggest liver dysfunction, as bile pigment changes cause dark urine and pale stools. Bone marrow effects don’t explain the hepatobiliary symptoms, making this choice incorrect.

Choice C reason: Iatrogenic skin disease might involve rashes or lesions, but jaundice, dark urine, and light stools point to liver or bile duct issues. These symptoms result from impaired bilirubin metabolism, not cutaneous pathology. This choice doesn’t align with the systemic hepatobiliary symptoms described, making it incorrect.

Choice D reason: Drug-induced liver toxicity, such as from acetaminophen or statins, impairs bilirubin metabolism, causing jaundice, dark urine (bilirubinuria), and light stools (reduced bile). Malaise, nausea, and vomiting reflect systemic effects of liver dysfunction. This matches the patient’s symptoms, making it the most likely diagnosis and correct choice.