A nurse is providing preoperative teaching to an older adult female client who is scheduled for a laminectomy and uses supplements. Which of the following supplements should the nurse identify as increasing the client's risk for hypotension during surgery?

Rationale: A. Probiotics: Probiotics are used to support gastrointestinal and immune health and do not significantly affect blood pressure or pose a known risk for intraoperative hypotension. B. Black Cohosh: Black cohosh is often used to manage menopausal symptoms and is known to cause vasodilation, which can lower blood pressure. When combined with anesthetic agents, it can potentiate hypotensive effects during surgery. C. Soy: Soy is consumed for its phytoestrogenic effects but does not have a direct or significant hypotensive action that increases surgical risk. Its impact on intraoperative blood pressure is minimal. D. Flaxseed: Flaxseed may offer mild antihypertensive effects over time due to its omega-3 content, but it is not typically associated with clinically significant drops in blood pressure during surgery.