A nurse in a clinic is assessing a 60-year-old client at an annual examination. The client asks the nurse about receiving a shingles vaccination. The nurse should identify that which of the following medications prescribed to the client is a contraindication for receiving this vaccine?

A. Hang the TPN solution to gravity to infuse: TPN solutions are typically administered using an infusion pump to control the rate of infusion accurately. Hanging the solution to gravity is not recommended because it may lead to inconsistent flow rates and inaccurate delivery of nutrients.
B. Titrate TPN solution to blood pressure: TPN solutions are not titrated based on blood pressure.

The composition and rate of TPN infusion are typically determined by the client's nutritional needs and metabolic status, not blood pressure.

C. Monitor the client's weight daily: Monitoring the client's weight daily is essential when administering TPN to assess for fluid balance, nutritional status, and response to therapy. Changes in weight can indicate fluid retention, dehydration, or changes in nutritional status, which may require adjustments to the TPN regimen.
D. Obtain the client's blood glucose level weekly: Blood glucose levels should be monitored frequently in clients receiving TPN, as hyperglycemia is a common complication. Weekly monitoring may not be sufficient to detect and manage hyperglycemia promptly. Therefore,
blood glucose levels are typically monitored more frequently, such as multiple times daily or according to institutional protocols.

A. Constipation: Constipation is not a commonly reported adverse effect of clopidogrel.

Therefore, it is not necessary to instruct the client to monitor and report constipation as an adverse effect.
B. Weight loss: Weight loss is not a commonly reported adverse effect of clopidogrel. Therefore, it is not necessary to instruct the client to monitor and report weight loss as an adverse effect.
C. Bruising: Clopidogrel is an antiplatelet medication that inhibits platelet aggregation.

Therefore, one of the potential adverse effects is an increased risk of bleeding, which can

manifest as easy bruising or prolonged bleeding from minor injuries. Instructing the client to monitor and report bruising is important for early detection of bleeding complications.
D. Blurred vision: Blurred vision is not a commonly reported adverse effect of clopidogrel.

Therefore, it is not necessary to instruct the client to monitor and report blurred vision as an adverse effect.