A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

A. Peanuts:
While peanut allergies can be severe and life-threatening, they are not a contraindication to receiving the influenza vaccine. Influenza vaccines are not made with peanut-derived ingredients and do not pose a risk to individuals with peanut allergies.
B. Milk:
Milk allergies are not a contraindication to receiving the influenza vaccine. Influenza vaccines are typically free of milk-derived ingredients and do not contain significant amounts of milk proteins that would trigger an allergic reaction in individuals with milk allergies.
C. Shellfish:
Shellfish allergies are not a contraindication to receiving the influenza vaccine. Influenza vaccines are not derived from shellfish and do not contain shellfish proteins that could cause an allergic reaction in individuals with shellfish allergies.

D. Eggs:
This is the correct choice. In the past, some influenza vaccines were prepared using egg-based methods, which could pose a risk to individuals with severe egg allergies. However, most modern influenza vaccines, including those approved for administration in the United States, have extremely low egg protein content. The majority of individuals with egg allergies can safely receive the influenza vaccine, but those with a history of severe egg allergy may still need to consult with their healthcare provider before vaccination.

A. Correct Answer: St. John's Wort
Explanation: The nurse should advise the client to avoid taking St. John's Wort. St. John's Wort is an herbal supplement commonly used to treat depression and anxiety. However, it can have significant interactions with various medications, including sertraline. Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. St. John's Wort can increase serotonin levels in the brain, and when combined with medications that also affect serotonin levels (such as sertraline), it can lead to a potentially dangerous condition known as serotonin syndrome. Therefore, it's important to avoid St. John's Wort while taking sertraline to prevent adverse effects and interactions.
B. Incorrect Explanation: Coenzyme Q10
Explanation: Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that plays a role in energy production within cells. While CoQ10 is generally considered safe, it does not have known interactions with sertraline. Therefore, the nurse would not necessarily advise the client to avoid CoQ10 solely based on its potential interaction with sertraline.
C. Incorrect Explanation: Black Cohosh
Explanation: Black cohosh is an herbal supplement often used to manage symptoms of menopause. It is not typically known to have significant interactions with sertraline. However, it's important for the client to discuss any supplements with their healthcare provider before starting them, especially when taking prescribed medications. The nurse might not necessarily advise the client to avoid black cohosh unless there are specific concerns based on the client's medical history.
D. Incorrect Explanation: Ginger Root
Explanation: Ginger root is a commonly used spice and herbal remedy. It does not have known interactions with sertraline and is generally considered safe for most people. However, as with any supplement, it's a good practice to consult with a healthcare provider before starting it, especially when taking prescribed medications like sertraline. The nurse would not necessarily advise the client to avoid ginger root without specific reasons related to the client's health.