The nurse would recognize that additional teaching is necessary if the nurse finds the client taking cyclosporine while:
1. drinking milk.
2. eating fish.
3. drinking grapefruit juice.
4. eating leafy green vegetables.
Correct Answer: 3
Rationale 1: Drinking milk is not contraindicated with cyclosporine.
Rationale 2: Eating fish is not contraindicated with cyclosporine.
Rationale 3: Drinking grapefruit juice concurrently can increase cyclosporine levels by 50–200%.
Rationale 4: Eating leafy green vegetables is not contraindicated with cyclosporine.
Global Rationale: Grapefruit juice significantly increases cyclosporine levels, and should be avoided or eliminated while on immunosuppressant therapy. Teach the patient to avoid or eliminate grapefruit and grapefruit juice while on cyclosporine. Flavored beverages without juice are permissible. Drinking milk, eating fish, and eating leafy green vegetables are not contraindicated.
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