A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client?

Choice A reason: Nausea and diarrhea are possible side effects of ginkgo biloba, but they are not as serious or common as the risk of bleeding caused by the interaction with aspirin and non-steroidal anti-inflammatory drugs. Therefore, this information is not as important as choice c.

Choice B reason: Anxiety and headaches are not associated with the use of ginkgo biloba, but rather with the underlying condition of multiple sclerosis. Therefore, this information is not relevant or accurate for this client.

Choice C reason: Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo biloba, as both substances have antiplatelet effects that can increase the risk of bleeding. Therefore, this information is most important for the nurse to include in the teaching plan for this client, as the client should avoid taking these drugs while using ginkgo biloba or inform the healthcare provider if they are prescribed.

Choice D reason: Ginkgo biloba use should be limited and not taken during pregnancy, as there is insufficient evidence about its safety and efficacy for pregnant women. However, this information is not as important as choice c, as the client may not be pregnant or planning to become pregnant.

Choice A reason: Hematemesis is the vomiting of blood, which can indicate a serious gastrointestinal bleeding caused by ibuprofen. This is a life-threatening condition that requires immediate medical attention. Therefore, the nurse should report this finding to the healthcare provider as soon as possible.

Choice B reason: Insomnia is the difficulty in falling asleep or staying asleep. It can be a side effect of ibuprofen, but it is not as serious or urgent as hematemesis. The nurse can advise the client to take ibuprofen with food or milk, avoid caffeine and alcohol, and practice good sleep hygiene.

Choice C reason: Dizziness is the feeling of lightheadedness, faintness, or unsteadiness. It can also be a side effect of ibuprofen, but it is usually mild and transient. The nurse can instruct the client to rise slowly from a sitting or lying position, drink plenty of fluids, and avoid driving or operating machinery if dizzy.

Choice D reason: Nausea is the feeling of discomfort or unease in the stomach that may lead to vomiting. It can also be a side effect of ibuprofen, but it is usually manageable with simple measures. The nurse can suggest the client to take ibuprofen with food or milk, eat small and frequent meals, and avoid spicy or fatty foods.