A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has been changed by the physician.
What adverse effects will the nurse advise the client and family to watch?

Choice A rationale

Misoprostol (Cytotec) is contraindicated in pregnant women because it can induce labor or cause miscarriages. It is sometimes used in obstetrics to induce labor or to treat postpartum hemorrhage, but it should never be used in pregnant women to treat peptic ulcers.
Choice B rationale
There is no contraindication for using misoprostol in a client who has osteoarthritis.
Choice C rationale
Misoprostol does not interact with medications typically used to treat urinary tract infections, and there is no contraindication for its use in these clients.
Choice D rationale
Misoprostol does not interact with medications typically used to treat kidney stones, and there is no contraindication for its use in these clients.

Choice A rationale
While medication can be part of an effective treatment plan for anxiety disorders, it is not typically the first line of treatment. Medication alone is not considered the most productive way to treat anxiety disorders.
Choice B rationale
Uncovering and addressing the cause of anxiety is considered an effective approach to treating anxiety disorders. This often involves cognitive behavioral therapy (CBT), which helps individuals change negative thought patterns and develop coping strategies.
Choice C rationale
Allowing the client to self-medicate with over-the-counter (OTC) medications is not recommended. OTC medications may not be effective in treating anxiety disorders and could potentially have harmful interactions with other medications.
Choice D rationale

Immediately starting multiple-drug therapy is not typically the first line of treatment for anxiety disorders. It’s important to start with one medication and monitor its effectiveness before adding additional medications.