A nurse is providing teaching to a client who reports smoking 3 packs of cigarettes per day and has a prescription for nicotine gum. Which of the following instructions should the nurse include in the teaching?

A. Prior episode of kidney stones: A history of kidney stones is not a contraindication to prednisone therapy. However, it may require monitoring due to potential fluid and electrolyte imbalances associated with corticosteroid use.
B. Taking levothyroxine orally: Taking levothyroxine orally is not a contraindication to prednisone therapy. However, concurrent use of corticosteroids and levothyroxine may require dosage adjustments of both medications due to potential interactions.
C. Has a systemic fungal infection: Corticosteroids like prednisone can suppress the immune system, increasing the risk of fungal infections and worsening existing fungal infections.
Therefore, the presence of a systemic fungal infection is a contraindication to corticosteroid therapy.
D. History of asthma: Asthma is not a contraindication to prednisone therapy. In fact, prednisone is commonly used as a treatment for asthma exacerbations. However, caution may be needed in individuals with asthma to avoid exacerbating symptoms or complications.

A. Hypotension: Hypotension can occur as an adverse effect of fentanyl, particularly if the client experiences excessive sedation or respiratory depression. Fentanyl is a potent opioid analgesic
that can cause vasodilation and a decrease in blood pressure, especially when used in high doses or in susceptible individuals.
B. Tachycardia: Tachycardia is not a typical adverse effect of fentanyl. Opioids like fentanyl typically cause bradycardia or have minimal effects on heart rate.
C. Diarrhea: Diarrhea is not a common adverse effect of fentanyl. Opioids more commonly cause constipation due to their effects on gastrointestinal motility.

D. Insomnia: Insomnia is not a typical adverse effect of fentanyl. Opioids typically cause sedation and can lead to drowsiness or somnolence, especially during initial use or when administered in high doses.