A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?

A) Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs: This information is crucial to include in the teaching plan because feverfew has been reported to interact with medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), potentially increasing the risk of bleeding. Clients need to be aware of potential drug interactions to prevent adverse effects and ensure safe use of feverfew.

B) Those with allergies to chamomile, ragweed, or yarrow should not take feverfew: While this is important information to consider, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, it is still important to assess for allergies and sensitivities to prevent allergic reactions.

C) Increased anxiety and nervousness have been reported by those taking feverfew: Although this is a potential side effect of feverfew, it may not be the most important information to include in the teaching plan for a client who is experiencing fewer headaches with feverfew use. The focus should be on the client's positive response to the herbal remedy and potential interactions with other medications.

D) Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew: While this is important information regarding potential side effects of feverfew, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, clients should be informed about possible adverse effects to monitor for and report to their healthcare provider if they occur.

A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.

B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.

C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.

D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.