A client with atrial fibrillation has been prescribed dabigatran.
What instruction should the nurse include in this client’s teaching plan?

Choice A rationale

While a family history of mental illness is important information to obtain when planning care for a client with major depression, it is not the most important information when the client is receiving a new prescription for duloxetine. Family history can provide insight into the client’s risk factors for depression, but it does not directly impact the safety or efficacy of duloxetine.

Choice B rationale

Weight change in the last month is not the most important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine. While significant weight changes can be a symptom of depression and should be monitored, they do not directly impact the safety or efficacy of duloxetine.

Choice C rationale

Liver function laboratory results are the most important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine.

Duloxetine is metabolized in the liver, and abnormal liver function can affect the metabolism and elimination of the drug, potentially leading to increased side effects or decreased effectiveness. Therefore, it is crucial to assess liver function before and during treatment with duloxetine.

Choice D rationale

While recent use of other antidepressants is important information to obtain when planning care for a client with major depression who is receiving a new prescription for duloxetine, it is not the most important information. This information can help prevent drug interactions and serotonin syndrome, a potentially life-threatening condition. However, liver function has a more direct impact on the safety and efficacy of duloxetine.

Choice A rationale

Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma.

Choice B rationale

Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.

Choice C rationale

Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.

Choice D rationale

Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.