A nurse is caring for a client who is taking fluticasone due to chronic allergies. The nurse should monitor the client for which of the following adverse effects?

A. Inhibits the production of leukotrienes and histamine, preventing further asthma attacks: This statement is misleading. Omalizumab does not directly inhibit the production of leukotrienes or histamine; rather, it works by targeting IgE, which is involved in the allergic response.

B. Inhibits mast cells from releasing histamine, preventing further asthma attacks: While omalizumab does reduce the overall allergic response, it does so by binding to IgE rather than directly inhibiting mast cell activity. Therefore, this description does not accurately represent its primary mechanism of action.

C. Selectively binds to IgE, reducing allergic mediators and asthma attacks: This statement correctly describes the mechanism of action of omalizumab. By binding to immunoglobulin E (IgE), omalizumab prevents IgE from attaching to mast cells and basophils, thus reducing the release of allergic mediators that contribute to asthma attacks.

D. Stimulates alpha-adrenergic receptors to assist in reduction of allergic-related symptoms: This statement is incorrect. Omalizumab does not stimulate alpha-adrenergic receptors; such action is associated with certain bronchodilators. Omalizumab specifically targets IgE to mitigate allergic responses.

A) Palpitations: While palpitations can be concerning for many medications, they are not a commonly reported side effect of dextromethorphan. This medication primarily acts as a cough suppressant and does not typically have cardiovascular effects that would lead to palpitations. Therefore, clients should not primarily monitor for this side effect when taking dextromethorphan.

B) Hypertension: Dextromethorphan is not generally associated with causing hypertension. Its main action is to suppress the cough reflex, and it does not typically influence blood pressure levels. Patients taking this medication should focus on other side effects rather than worrying about hypertension.

C) Ataxia: Ataxia, or impaired coordination, is a notable adverse effect associated with dextromethorphan, especially at higher doses or when combined with other central nervous system depressants like alcohol. This side effect can lead to dizziness and increased risk of falls or accidents, making it important for clients to be aware of their coordination and alertness levels while on this medication. Advising patients to avoid driving or operating heavy machinery if they experience ataxia is essential for their safety.

D) Diarrhea: Diarrhea is not a common adverse effect of dextromethorphan. The medication is primarily used for its antitussive properties, and gastrointestinal disturbances like diarrhea are generally not associated with its use. If patients experience gastrointestinal symptoms while taking this medication, they may need to consider other factors or medications that could be contributing to those symptoms.