The diet is the whole drug
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client started on phenelzine, a monoamine oxidase inhibitor (MAOI), asks about dietary restrictions. Which food should the nurse teach the client to avoid?
Answer: B. MAOIs block breakdown of tyramine. Eating tyramine-rich foods (aged cheese, cured meats, fermented products, draft beer) can trigger a hypertensive crisis. Fresh chicken, white rice, and apple juice are low in tyramine and safe.
Question 2 of 5
A client is being discharged on a transdermal selegiline patch, an MAOI. Which dietary teaching is essential?
Answer: B. MAOIs require avoidance of tyramine-rich foods to prevent hypertensive crisis. These include aged cheeses, cured or smoked meats, fermented soy products, sauerkraut, draft beer, and certain wines. The client must learn to read labels and avoid these foods.
Question 3 of 5
A client with cirrhosis and pruritus from jaundice is prescribed cholestyramine. The nurse explains that this medication relieves itching by:
Answer: A. Pruritus in cholestatic liver disease is caused by bile salts deposited in the skin. Cholestyramine is a bile acid sequestrant that binds bile salts in the intestine so they are excreted in the stool rather than reabsorbed, lowering circulating bile salt levels and reducing itching. It does not numb the skin, increase bile production, or act as an antihistamine.
Question 4 of 5
A client taking an MAOI antidepressant should avoid which food to prevent hypertensive crisis?
Answer: B. Tyramine-rich foods (aged cheese, cured/smoked meats, fermented foods, draft beer) with an MAOI can trigger a hypertensive crisis.
Question 5 of 5
A client taking phenelzine, a monoamine oxidase inhibitor (MAOI), reports a severe throbbing headache, neck stiffness, and palpitations after eating aged cheese. Which complication should the nurse suspect?
Answer: B. Aged cheeses are high in tyramine. When combined with an MAOI, tyramine cannot be metabolized and causes a hypertensive crisis, marked by severe headache, neck stiffness, palpitations, and dangerously elevated blood pressure. This is a medical emergency.
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References
Clinical references for this topic
