A nurse in a clinic is assessing a 60-year-old client at an annual examination. The client asks the nurse about receiving a shingles vaccination. The nurse should identify that which of the following medications prescribed to the client is a contraindication for receiving this vaccine?

A. Peripheral edema: Peripheral edema is not a commonly reported adverse effect of paroxetine.

It is more commonly associated with medications such as calcium channel blockers and certain antihypertensive agents.
B. Alopecia: Alopecia, or hair loss, is not a commonly reported adverse effect of paroxetine. Hair loss is more commonly associated with certain chemotherapy agents and other medications.
C. Drowsiness: Drowsiness is a common side effect of paroxetine and other selective serotonin reuptake inhibitors (SSRIs). Clients should be advised to monitor for drowsiness, especially when starting the medication or adjusting the dosage. Drowsiness can affect activities such as driving or operating machinery and may indicate the need for dosage adjustment or medication change.
D. Tinnitus: Tinnitus, or ringing in the ears, is not a commonly reported adverse effect of paroxetine. It is more commonly associated with medications such as certain antibiotics (e.g., aminoglycosides) and high-dose aspirin.

A. The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B. The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C. The vial was out of the refrigerator for 2 hr before the medication was administered:

Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.