A client who reports routine consumption of more than three alcoholic beverages per day asks about taking acetaminophen when needed for occasional recurrent pain. What will the nurse tell the client?

A) Hold metformin 24 hours to 48 hours before the CT. This is correct because it reduces the chance of metformin accumulating in the blood and causing lactic acidosis when combined with the contrast dye.

B) Hold metformin 48 hours after the CT. This is also correct because it allows time for the contrast dye to be eliminated from the body before resuming metformin.

C) Double the metformin dose after the CT. This is incorrect and dangerous because it can cause hypoglycemia, low blood sugar, which can lead to confusion, seizures, coma, or death. D) Take metformin as scheduled the day of the CT. This is incorrect and risky because it can result in high levels of metformin in the blood when mixed with the contrast dye, increasing the likelihood of lactic acidosis.

E) Resume metformin at half dose after the CT. This is incorrect and unnecessary because there is no evidence that reducing the dose of metformin after a CT scan with contrast dye has any benefit or reduces any harm.

a) Mentioning respiratory depression is not directly addressing the reported need for increased pain relief and might cause unnecessary concern about a side effect.

b) Accusing the client of addiction without further assessment or consideration of medical guidance is not appropriate and may damage the therapeutic relationship.

c) Developing tolerance to opioids is a common phenomenon, and discussing an increase in dosage with the healthcare provider is a reasonable response.

d) Advising the client to take the medication more often without consulting the healthcare provider can lead to unsafe practices and is not recommended.