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
Guaifenesin (Mucinex) is an expectorant, which means it helps loosen mucus in your airways. This makes it easier for you to cough up phlegm. So, coughing up phlegm after taking Mucinex does not necessarily mean there is more pathology present.
Choice B rationale
Coughing up phlegm is not typically indicative of an allergic reaction to Mucinex. Allergic reactions would more likely involve symptoms such as rash, itching, swelling, severe dizziness, or trouble breathing.
Choice C rationale

While any new or worsening symptoms should be reported to a healthcare provider, coughing up phlegm after taking Mucinex does not necessarily require further investigation. It is a normal response to the medication, which is designed to help clear mucus from the airways.
Choice D rationale
Guaifenesin (Mucinex) works by thinning and loosening mucus in the airways, clearing congestion, and making breathing easier. Therefore, coughing up phlegm is a normal response to the medication.