A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?

Choice A reason: This is incorrect because reporting symptoms that last longer than 2 days is not specific to guaifenesin. This is a general instruction for any patient with a sinus infection, regardless of the medication they are taking.

Choice B reason: This is incorrect because reporting clear-colored sputum to the prescriber is not necessary. Clear-colored sputum indicates that the infection is improving and the mucus is thinning. This is a desired effect of guaifenesin, not a problem that needs to be reported.

Choice C reason: This is incorrect because guaifenesin does not have sedating effects. Guaifenesin is an expectorant that helps to break up and expel mucus from the respiratory tract. It does not cause drowsiness or impair the ability to drive or operate machinery.

Choice D reason: This is correct because increasing fluid intake is an important instruction for a patient taking guaifenesin. Fluids help to hydrate the body and thin the mucus, making it easier to cough up and clear the sinuses. Fluids also help to prevent dehydration and dryness of the mucous membranes.

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.