A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?

Choice A reason: Bupropion is known to cause side effects such as insomnia and weight loss. These side effects are due to its stimulant properties, which can interfere with sleep patterns and suppress appetite1. Patients should be informed about these potential side effects so they can monitor their symptoms and seek medical advice if necessary.

Choice B reason: While changes in taste can occur with some medications, it is not a common side effect of bupropion. Therefore, it is not necessary to specifically instruct patients to notify their healthcare provider about changes in taste when taking bupropion.

Choice C reason: There is no specific requirement to administer bupropion with 8 ounces of water. Bupropion can be taken with or without food, and the amount of water consumed with the medication does not impact its effectiveness.

Choice D reason: Consuming tyramine-free foods is crucial for patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis. However, bupropion is not an MAOI, so this dietary restriction is not applicable.

Choice A Reason

Morphine, an opioid analgesic, is commonly prescribed for severe pain management, such as in cases of metastatic cancer. One of the well-known side effects of morphine is constipation. This occurs because opioids slow down gastrointestinal motility, leading to harder and less frequent stools. Therefore, it is crucial for patients taking morphine to monitor their bowel movements and use stool softeners or laxatives as needed to prevent constipation. This choice indicates that the client understands the importance of managing this common side effect, which can significantly impact their comfort and quality of life.

Choice B Reason

Grapefruit juice is known to interact with various medications by inhibiting the cytochrome P450 3A4 (CYP3A4) enzyme in the liver, which can lead to increased blood levels of certain drugs. However, morphine is primarily metabolized by the liver enzyme UGT2B7, not CYP3A4. Therefore, grapefruit juice does not significantly affect morphine metabolism. This choice reflects a misunderstanding of the specific interactions relevant to morphine.

Choice C Reason

Taking a benzodiazepine at the same time as morphine can be dangerous due to the risk of additive central nervous system (CNS) depression. Both morphine and benzodiazepines can cause sedation, respiratory depression, and impaired cognitive and motor functions. Concurrent use increases the risk of severe side effects, including potentially life-threatening respiratory depression. This choice indicates a lack of understanding of the risks associated with combining these medications.

Choice D Reason

While it is important to monitor for signs of agitation and insomnia, these are not the primary concerns associated with morphine use. Morphine is more likely to cause sedation rather than agitation, and insomnia is not a common side effect. This choice does not reflect a comprehensive understanding of the primary side effects and necessary precautions related to morphine use.