The nurse is educating a client on foods to avoid when taking iodine supplements in a client with Graves' disease. Which of the following would be included in this teaching plan? (Select all that apply)

Choice A reason: Diphenhydramine, an antihistamine, treats allergies or sleep issues by blocking histamine, not addressing heart failure’s fluid overload or cardiac dysfunction.

Choice B reason: Epinephrine boosts heart rate and pressure in emergencies like anaphylaxis, but it worsens heart failure by increasing cardiac workload, not reducing fluid.

Choice C reason: Propylthiouracil treats hyperthyroidism by inhibiting thyroid hormone, unrelated to heart failure’s need for fluid management or cardiac support.

Choice D reason: Furosemide, a loop diuretic, reduces fluid overload in heart failure by increasing urine output, relieving pulmonary edema and systemic congestion effectively.

Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.

Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.

Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.

Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.

Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.