A nurse is caring for a client who has a history of cardiac arrhythmias and is taking verapamil. For which of the following reasons should the nurse consult the pharmacist?

A. The client's liver function test results are within the expected reference range: While monitoring liver function tests is essential for clients taking isoniazid and rifampin due to
potential hepatotoxicity, normal liver function test results do not necessarily indicate adherence to the medication regimen. Adherence is best assessed by the client's response to treatment, such as improvement in symptoms and resolution of the infection.
B. The client has a positive purified protein derivative test: A positive purified protein derivative (PPD) test indicates exposure to Mycobacterium tuberculosis but does not provide information about the client's adherence to the medication regimen for tuberculosis treatment. Adherence to treatment is determined by factors such as medication compliance and therapeutic response.
C. The client tests negative for HIV: The client's HIV status is not directly related to adherence to the tuberculosis medication regimen. While co-infection with HIV can impact the management of tuberculosis, testing negative for HIV does not confirm adherence to tuberculosis treatment.
D. The client has a negative sputum culture: A negative sputum culture indicates the absence of viable Mycobacterium tuberculosis organisms in the sputum sample and suggests effective
treatment and adherence to the medication regimen. Monitoring sputum culture conversion is a key indicator of treatment success in tuberculosis therapy.

A. Bruxism: Bruxism, or teeth grinding, is a potential adverse effect of citalopram but is generally less severe than confusion. While it should be monitored and reported if severe or persistent, it is not typically considered a priority adverse effect.
B. Confusion: Confusion can indicate a serious adverse reaction or complication, such as serotonin syndrome, which is a potentially life-threatening condition associated with the use of selective serotonin reuptake inhibitors (SSRIs) like citalopram. Therefore, confusion is the priority adverse effect to report to the provider.
C. Insomnia: Insomnia is a common side effect of citalopram and other SSRIs but is generally less severe than confusion. It should be monitored and reported if severe or persistent, but it is not typically considered a priority adverse effect.
D. Weight loss: Weight loss can occur as a side effect of citalopram but is generally less severe than confusion. It should be monitored and reported if excessive or rapid, but it is not typically considered a priority adverse effect.