A nurse provided education to a client who was prescribed sitagliptin. Which client statement indicates an understanding of the education?

A. Ileus: Octreotide can significantly slow gastrointestinal motility by inhibiting the secretion of gastrointestinal hormones and reducing peristalsis. Development of an ileus is a serious complication because it can lead to bowel obstruction, abdominal distention, pain, and potential ischemia, requiring immediate medical evaluation.

B. Sinusitis: While sinusitis can occur as a nonspecific side effect, it is generally mild and not life-threatening. It does not directly relate to the pharmacologic effects of octreotide on the gastrointestinal or endocrine systems.

C. Vomiting: Vomiting is a known but less severe gastrointestinal side effect of octreotide. Although uncomfortable, it is usually self-limiting and can be managed with supportive care or dose adjustment, unlike an ileus.

D. Headache: Headaches are a common and generally mild adverse effect associated with octreotide. They are typically transient and do not indicate a serious pharmacologic complication or systemic risk requiring immediate intervention.

A. A client with a low serum albumin: Low albumin levels affect protein binding of highly protein-bound drugs, increasing the free drug concentration and potential toxicity. While this influences drug distribution and effects, it does not directly impair hepatic metabolism.

B. A client diagnosed with renal failure: Renal failure primarily affects drug excretion rather than metabolism. Drugs cleared by the kidneys may accumulate, but hepatic metabolism may remain largely intact unless concomitant liver disease is present.

C. A client with slowed gastric emptying: Slowed gastric emptying affects the rate and sometimes the extent of drug absorption. While this can delay onset of action, it does not significantly alter hepatic metabolism of the medication.

D. A client with cirrhosis of the liver: Cirrhosis significantly impairs hepatic function, reducing the liver’s ability to metabolize drugs through phase I and phase II reactions. This increases drug half-life, risk of accumulation, and potential toxicity, making these clients the highest risk for decreased drug metabolism.