On an inpatient unit, which task is the nurse's priority when caring for a client taking phenelzine who ate cheese and salami?

On an inpatient unit, which task is the nurse's priority when caring for a client taking phenelzine who ate cheese and salami?

• A. Talk to a client who has depressive disorder about their past coping strategies.
• B. Check the vital signs of a client who takes phenelzine and ate their roommate's cheese and salami.
• C. Complete an Abnormal Involuntary Movement Scale for a client who takes risperidone.
• D. None of the above.

Answer: (B)

The key concept here is recognizing the dangerous interaction between monoamine oxidase inhibitors (MAOIs) like phenelzine and tyramine-rich foods. Cheese and salami are high in tyramine, and taking an MAOI can cause a sudden release of norepinephrine, leading to a hypertensive crisis. Because this reaction can escalate quickly and become life-threatening, the nurse’s priority is to monitor the patient’s cardiovascular status by checking vital signs, especially blood pressure, and to watch for symptoms such as severe headache, palpitations, flushing, or sweating. This immediate assessment guides urgent actions: if blood pressure is elevated or symptoms develop, the prescriber must be notified, and appropriate interventions to control blood pressure should be started. In contrast, addressing coping strategies for depressive illness or performing an EPS assessment for another medication does not address the acute medical risk posed by the MAOI–tyramine interaction. So, prioritizing vital signs to detect a hypertensive crisis is the most critical task in this scenario.

The key concept here is recognizing the dangerous interaction between monoamine oxidase inhibitors (MAOIs) like phenelzine and tyramine-rich foods. Cheese and salami are high in tyramine, and taking an MAOI can cause a sudden release of norepinephrine, leading to a hypertensive crisis. Because this reaction can escalate quickly and become life-threatening, the nurse’s priority is to monitor the patient’s cardiovascular status by checking vital signs, especially blood pressure, and to watch for symptoms such as severe headache, palpitations, flushing, or sweating.

This immediate assessment guides urgent actions: if blood pressure is elevated or symptoms develop, the prescriber must be notified, and appropriate interventions to control blood pressure should be started. In contrast, addressing coping strategies for depressive illness or performing an EPS assessment for another medication does not address the acute medical risk posed by the MAOI–tyramine interaction. So, prioritizing vital signs to detect a hypertensive crisis is the most critical task in this scenario.