A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine.
Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine?

Raloxifene is a medication used to prevent and treat osteoporosis in postmenopausal women.

Osteoporosis is a condition that causes bones to become thin and weak, increasing the risk of fractures.

Raloxifene belongs to a class of drugs called selective estrogen receptor modulators (SERMs), which mimic the effects of estrogen on bone density. Choice B is wrong because raloxifene may increase the risk of deep-vein thrombosis (DVT), a type of blood clot that forms in a vein deep in the body. DVT can cause pain, swelling, and redness in the affected limb, and can lead to serious complications such as pulmonary embolism (PE), a blood clot in the lung.

Raloxifene should not be used by people who have or had DVT or PE. Choice C is wrong because raloxifene is not used to treat urinary tract infection (UTI), an infection that affects the bladder, kidneys, or ureters. UTI can cause symptoms such as burning or pain when urinating, frequent or urgent urination, blood in the urine, or fever.

UTI is usually treated with antibiotics.

Choice D is wrong because raloxifene is not used to treat hypothyroidism, a condition that occurs when the thyroid gland does not produce enough thyroid hormone.

Thyroid hormone regulates the body’s metabolism, growth, and development. Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, or depression.

Hypothyroidism is usually treated with synthetic thyroid hormone replacement.

The nurse should advise the client to avoid taking St. John’s Wort with sertraline because it can increase the risk of a rare but serious condition called serotonin syndrome. Serotonin syndrome can cause symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhoea.

Choice B. Black cohosh is wrong because it is a herbal supplement that is used to treat menopausal symptoms and has no known interaction with sertraline.

Choice C. Coenzyme Q is wrong because it is a natural substance that is involved in energy production and has no known interaction with sertraline.

Choice D. Ginger root is wrong because it is a spice that is used to treat nausea and has no known interaction with sertraline.