A nurse is assessing a client who is taking clozapine. For which of the following adverse effects should the nurse monitor and report to the provider?

Rationale:

A. Alkaline phosphatase: This enzyme is typically used to assess liver or bone disorders, not renal function. Although some values may rise due to medications or illness, it is not a primary marker for kidney health in transplant clients.

B. Amylase: Amylase is used to evaluate pancreatic function and is not directly related to kidney function. It may be elevated in pancreatitis or abdominal conditions, but it does not provide information about renal performance.

C. Creatinine: Serum creatinine is a key indicator of renal function and is commonly monitored alongside BUN in clients taking nephrotoxic drugs like cyclosporine. Elevations may signal impaired kidney function or transplant rejection.

D. Bilirubin: Bilirubin reflects liver function and bile metabolism rather than kidney function. Although important in overall health assessment, it is not used to evaluate renal function in clients post-transplant.

Rationale:

A. Fibrocystic breast condition: This benign breast disorder does not interfere with the use of oral contraceptives. In fact, hormonal birth control may sometimes reduce breast pain and nodularity associated with this condition.

B. Hypertension: High blood pressure is a known contraindication for oral contraceptive use, especially if it is uncontrolled. Estrogen-containing contraceptives can further elevate blood pressure and increase the risk of cardiovascular events such as stroke or myocardial infarction.

C. Fibromyalgia: Fibromyalgia does not interact with oral contraceptives and is not a contraindication. While hormonal changes may influence pain perception, there is no direct risk in using contraceptives for someone with this condition.

D. Asthma: Asthma is not a contraindication to using oral contraceptives. There is no evidence that hormonal contraceptives worsen asthma symptoms or interfere with its management.