A nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication?

Leukotriene receptor antagonists (LTRAs) like Montelukast are commonly used in the treatment of asthma. They work by blocking the action of leukotrienes, which are inflammatory substances that can cause narrowing and inflammation of the airways in individuals with asthma. By preventing this inflammation, LTRAs help to reduce asthma symptoms and prevent asthma attacks.

The other options mentioned in the statements are not accurate or appropriate for teaching about Montelukast. Taking the medication only when experiencing symptoms is not the recommended approach, as LTRAs are typically taken regularly as part of ongoing asthma management. The statement about the therapeutic effect taking several weeks to notice is not accurate, as Montelukast can start to provide symptom relief within a shorter timeframe.

Additionally, the statement about increasing fiber and fluid intake to prevent constipation is unrelated to the use of Montelukast and may not apply to this medication specifically.

The nurse must consider the following when obtaining a health history for a client with diabetes mellitus who has been taking glucocorticoids (prednisone) long-term for uncontrolled COPD:

1. Due to the use of long-term glucocorticoids, the medication must not be abruptly discontinued to avoid adrenal suppression. Abruptly stopping glucocorticoids can lead to adrenal insufficiency and a potentially life-threatening condition. Gradual tapering of the medication is necessary under medical supervision.
2. The use of long-term glucocorticoids may contribute to a spike in blood glucose levels. Glucocorticoids can cause insulin resistance and increase blood sugar levels, which can be problematic for individuals with diabetes mellitus.
3. The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection. Glucocorticoids can suppress the immune system, making the client more susceptible to infections. This is important to consider, especially in a hospital setting where the risk of acquiring infections may be higher.

Regarding the other options:

The client may develop low blood pressure: While glucocorticoids can cause fluid retention and increased blood pressure, they are not typically associated with low blood pressure.

The client will most likely experience more pain: The use of glucocorticoids is not directly related to increased pain perception. Pain management may be influenced by various factors, but it is not specifically attributed to long-term glucocorticoid use.