The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

A) Collecting a capillary glucose level is not indicated in response to hand tremors reported by a client taking pregabalin for fibromyalgia. Hand tremors are not typically associated with hypoglycemia, which is what capillary glucose levels assess. Therefore, this action does not directly address the reported symptom.

B) Notifying the healthcare provider is the most appropriate action in response to the client’s report of experiencing tremors while taking pregabalin. Hand tremors can be a potential adverse effect of pregabalin, and the healthcare provider should be informed to assess the severity of the symptom, consider alternative medications or dosage adjustments, and determine the need for further evaluation or intervention.

C) Obtaining orthostatic blood pressure readings is not indicated in response to hand tremors reported by a client taking pregabalin for fibromyalgia. Orthostatic blood pressure readings assess for changes in blood pressure upon position changes (e.g., from lying down to standing up) and are not directly relevant to the reported symptom of tremors.

D) Administering a PRN dose of an antianxiety drug is not the first-line intervention for hand tremors reported by a client taking pregabalin. While antianxiety medications may help alleviate symptoms of anxiety, they do not address the underlying cause of the tremors. Additionally, the client’s tremors may not necessarily be related to anxiety. Therefore, the nurse should prioritize notifying the healthcare provider for further assessment and management of the reported symptom.

A) CT scan that was performed six months earlier: A previous CT scan performed six months earlier does not necessarily require follow-up by the nurse. However, it would be important to review the results of the previous CT scan to compare findings and assess for any changes over time.

B) Takes metformin hydrochloride for type 2 diabetes mellitus: This is the correct answer. Metformin is excreted by the kidneys, and contrast media used in CT scans can potentially cause kidney damage, particularly in clients with pre-existing renal impairment. Therefore, clients taking metformin may be at increased risk of developing lactic acidosis if renal function is compromised. It is essential for the nurse to follow up on this information and coordinate with the healthcare provider to determine whether metformin should be temporarily discontinued before the CT scan and when it can be safely resumed.

C) Report of client’s sobriety for the last five years: The client’s sobriety status for the last five years is not directly relevant to the CT scan with contrast for evaluating pulmonary embolism. While substance use history is important for overall health assessment, it does not specifically require follow-up related to the CT scan.

D) Metal hip prosthesis was placed twenty years ago: The presence of a metal hip prosthesis placed twenty years ago may be relevant for certain imaging studies, such as magnetic resonance imaging (MRI) or metal artifact reduction sequence (MARS) MRI, but it is not directly related to the CT scan with contrast for pulmonary embolism evaluation. Therefore, it does not require immediate follow-up by the nurse in this context.