The nurse is caring for a client who is refusing to take their prescribed metformin (Glucophage). The nurse understands that the most common side effects of metformin are:

Choice A reason: Monitor the patient for addiction is not a necessary measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine is a Schedule V medication, which means that it has a low potential for abuse and dependence compared to other opioids. The nurse should follow the prescriber's order and the label instructions and use the lowest effective dose for the shortest duration. The nurse should also assess the patient's pain level, respiratory status, and cough frequency and severity.

Choice B reason: Advise the patient that the medication helps to thin out their secretions is an incorrect statement for the nurse to make when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine does not affect the viscosity or production of the mucus in the airways, but rather reduces the urge to cough. The nurse should advise the patient to drink plenty of fluids, use a humidifier, or use saline nasal spray to help loosen and clear the secretions.

Choice C reason: Advise the patient to minimize intake of beets is not a relevant measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Beets are a vegetable that are rich in antioxidants, fiber, and nitrates, which can lower blood pressure and improve blood flow. Beets do not interact with codeine or affect its metabolism or clearance. The nurse should encourage the patient to eat a balanced and nutritious diet, unless they have any dietary restrictions or allergies.

Choice D reason: Advise the patient that constipation is an adverse effect of the medication is the correct and appropriate measure for the nurse to take when administering codeine cough syrup, which is a medication that suppresses the cough reflex by acting on the brain¹. Codeine can also act on the opioid receptors in the gastrointestinal tract, which can reduce the peristalsis and cause constipation. The nurse should advise the patient to prevent or treat constipation by increasing their fluid and fiber intake, exercising regularly, and using laxatives or stool softeners as needed.

Choice A reason: Monoamine oxidase inhibitors (MAOIs) are not the correct class of medications to which escitalopram (Lexapro) belongs. MAOIs are a group of antidepressants that work by inhibiting the enzyme monoamine oxidase, which breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine. MAOIs can increase the levels of these neurotransmitters in the brain and improve mood and energy. However, MAOIs can also cause serious side effects and interactions with other drugs and foods, and they are not commonly used as firstline treatment for depression. Escitalopram is not an MAOI, and it should not be taken with MAOIs or within 14 days of stopping or starting MAOIs, as this can cause a dangerous drug interaction called serotonin syndrome.

Choice B reason: Betablockers are not the correct class of medications to which escitalopram (Lexapro) belongs. Betablockers are a group of drugs that work by blocking the beta receptors on the heart and blood vessels, which are stimulated by adrenaline and noradrenaline. Betablockers can lower the heart rate, blood pressure, and cardiac output, and they are used to treat conditions such as hypertension, angina, arrhythmias, and heart failure. Betablockers can also reduce anxiety and tremors, but they are not antidepressants and they do not affect serotonin levels. Escitalopram is not a betablocker, and it does not have any significant effect on the cardiovascular system.

Choice C reason: Benzodiazepines are not the correct class of medications to which escitalopram (Lexapro) belongs. Benzodiazepines are a group of drugs that work by enhancing the activity of the neurotransmitter gammaaminobutyric acid (GABA), which has a calming and sedating effect on the brain. Benzodiazepines are used to treat anxiety, insomnia, seizures, and muscle spasms, and they can also cause relaxation, drowsiness, and amnesia. Benzodiazepines are not antidepressants and they do not affect serotonin levels. Escitalopram is not a benzodiazepine, and it does not have any significant effect on GABA receptors .

Choice D reason: Selective serotonin reuptake inhibitors (SSRIs) are the correct class of medications to which escitalopram (Lexapro) belongs. SSRIs are a group of antidepressants that work by blocking the reuptake of serotonin by the nerve cells, which increases the availability of serotonin in the synaptic cleft. Serotonin is a neurotransmitter that regulates mood, appetite, sleep, and cognition, and low levels of serotonin are associated with depression and anxiety. SSRIs can improve the symptoms of depression and anxiety by enhancing the serotonin signaling in the brain. Escitalopram is an SSRI, and it is used to treat major depressive disorder and generalized anxiety disorder.