The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider?

A. Clients using the discus may experience decreased blood pressure:
Fluticasone propionate and salmeterol are a combination of a corticosteroid and a long-acting beta-agonist. While they help control asthma, they are not typically associated with decreased blood pressure. Instead, potential side effects might include increased heart rate or hypertension.

B. Explain that the client should not use the discus more than twice daily:
Fluticasone propionate and salmeterol combination inhalers are usually prescribed for twice-daily use to maintain control of asthma symptoms. Using the inhaler more frequently than prescribed could lead to increased side effects or diminished effectiveness.

C. When using the discus, have the client breathe out rapidly into the mouthpiece:
The correct technique for using a dry powder inhaler involves inhaling deeply and forcefully to ensure the medication reaches the lungs. Breathing out rapidly into the mouthpiece is incorrect and will not deliver the medication effectively.

D. Offer the discus to the client for use during an acute asthma attack:
The discus is used for long-term control and prevention of asthma symptoms, not for immediate relief during an acute asthma attack. A rescue inhaler, typically containing a short-acting beta-agonist like albuterol, is used for acute symptoms.

A. Notify the healthcare provider of lethargy:
Cimetidine can cause side effects such as confusion and lethargy, especially in the elderly or those with renal impairment. Reporting these symptoms to the healthcare provider is important for proper management and potential adjustment of treatment.

B. Decrease cigarette use to a pack per day:
This statement indicates a misunderstanding of the impact of smoking on peptic ulcer disease. Smoking can exacerbate ulcer symptoms and interfere with healing. The nurse should instruct the client to ideally quit smoking altogether rather than just reducing the amount.

C. Monitor for any signs of sexual dysfunction:
Cimetidine can cause sexual dysfunction, including decreased libido and erectile dysfunction. The client should be aware of this potential side effect and report any such issues to their healthcare provider for further evaluation and management.

D. Take the medication an hour after antacids:
Cimetidine should not be taken simultaneously with antacids as this can interfere with its absorption. Taking cimetidine an hour after antacids is a correct approach to avoid interaction and ensure effective medication action.