A female client with mild depression reports to the nurse of recently starting St. John's wo’t. Which information provided by the client requires further instruction?

A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.

B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.

C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.

D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.

A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.

B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.

C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.

D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.