A charge nurse is creating assignments for the next shift for several nurses and one of the nurses is pregnant. Which of the following clients should the charge nurse assign to a nurse who is not pregnant?

A. Levothyroxine is a thyroid hormone replacement medication commonly used to treat hypothyroidism. It is not associated with teratogenic effects when used appropriately.

B. Phenytoin is an anticonvulsant medication that is known to be teratogenic, especially when used during the first trimester of pregnancy. It is associated with an increased risk of congenital malformations, such as cleft palate and heart defects, in infants born to mothers who take the medication during pregnancy.

C. Magnesium oxide is a mineral supplement commonly used to treat constipation during pregnancy. It is not associated with teratogenic effects when used appropriately.

D. Ferrous sulfate is an iron supplement commonly used to treat chronic anemia during pregnancy. It is not associated with teratogenic effects when used appropriately.

Rationale for A: Decreased reflexes can indicate hypokalemia, an adverse effect of loop diuretics. Loop diuretics increase the excretion of potassium, which can lead to low potassium levels, manifesting as muscle weakness and diminished reflexes.

Rationale for B: Weight gain, especially in the context of heart failure, suggests fluid retention rather than an adverse effect of a loop diuretic, which is expected to reduce fluid retention by promoting diuresis.

Rationale for C: Increased urinary output is an expected effect of loop diuretics, as they are used to remove excess fluid. This would not be considered an adverse effect unless it leads to dehydration or electrolyte imbalances.

Rationale for D: Jugular vein distention indicates fluid overload, which would suggest that the diuretic is not effective or that the heart failure is worsening. It is not a direct adverse effect of the medication itself.