A nurse is assisting a provider with a client who is to undergo thoracentesis. In which of the following positions should the nurse place the client?

Choice A Reason:
Decreased dysrhythmias are not a therapeutic effect associated with aprepitant. Aprepitant is a neurokinin-1 (NK1) receptor antagonist used primarily to prevent chemotherapy-induced nausea and vomiting (CINV). It does not have a direct effect on cardiac rhythms.

Choice B Reason:
Absence of dizziness is not a specific therapeutic effect of aprepitant. While preventing dizziness can be a secondary benefit of controlling nausea and vomiting, aprepitant's primary function is not to treat dizziness but to block the action of substance P/neurokinin 1 (NK1) in the brain, which can cause vomiting.

Choice C Reason:
Decreased incisional pain is not a therapeutic effect of aprepitant. Aprepitant does not have analgesic properties and is not indicated for pain management. Its role is in the prevention of nausea and vomiting through its action as an NK1 receptor antagonist.

Choice D Reason:
Absence of nausea is the expected therapeutic effect of aprepitant. Aprepitant works by inhibiting the substance P/neurokinin 1 (NK1) receptor, which plays a significant role in the emetic process. By blocking this receptor, aprepitant augments the antiemetic activity of other agents like 5-HT3 receptor antagonists and corticosteroids to prevent acute and delayed phases of CINV.

Choice A Reason:
While age is a significant risk factor for osteoporosis, the threshold is typically considered to be above 50 years. At 45 years, while one may start to be at risk, it is not the most prominent factor without other contributing conditions.

Choice B Reason:
Smoking cigarettes is a well-established risk factor for osteoporosis. Tobacco use can lead to decreased bone density, and smokers are generally at a higher risk of fractures compared to non-smokers. Smoking affects the balance of hormones, such as estrogen, which is important for bone health, and it also impacts calcium absorption.

Choice C Reason:
The use of NSAIDs for pain relief is not typically listed as a direct risk factor for osteoporosis. However, chronic use of these medications can lead to gastrointestinal problems, which may indirectly affect bone health by impairing calcium absorption.

Choice D Reason:
Regular aerobic exercise is actually protective against osteoporosis. Weight-bearing exercises, such as walking and running, can help to maintain or increase bone density and are recommended as part of a healthy lifestyle to prevent osteoporosis.