A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

A. Insert the needle slowly and gently.

This statement is generally true for most injection techniques, including the Z-track method. Slow and gentle insertion helps minimize discomfort for the client and allows for better control over the needle's placement. However, the specific speed of insertion may vary depending on the nurse's technique and the client's skin condition.

B. Pull the skin 1.3 cm (1/2 inch) to the side.

This statement is correct. The Z-track technique involves pulling the skin laterally (to the side) by approximately 1.3 cm (1/2 inch) before inserting the needle. This lateral displacement of the skin creates a zigzag pathway for the medication, which helps prevent leakage or tracking of the medication along the injection site.

C. Aspirate for 5 to 10 seconds.

Aspiration, or pulling back on the plunger of the syringe after needle insertion, is not typically recommended for intramuscular injections, including those using the Z-track method. Aspiration may increase the risk of tissue trauma or damage to blood vessels. Since the Z-track technique is designed to minimize medication leakage into the subcutaneous tissue, aspiration is usually unnecessary.

D. Use a 45° angle of insertion.

The angle of insertion for the Z-track technique is typically 90 degrees (perpendicular) to the skin surface rather than 45 degrees. This angle allows for proper depth penetration into the muscle and ensures adequate delivery of the medication into the muscle tissue.

A. "You will need to take this medication on an empty stomach."

Lithium is typically taken with food to minimize gastrointestinal side effects. Instructing the client to take it on an empty stomach would be incorrect.

B. "You will need to stop this medication if you experience diarrhea."

Diarrhea is not typically a reason to stop lithium therapy. However, persistent diarrhea can lead to dehydration and electrolyte imbalances, which may affect lithium levels. It's essential for the client to report persistent diarrhea to their healthcare provider for further evaluation and management.

C. "You will need to consume a low-salt diet while on this medication."

A low-salt diet is not typically recommended with lithium therapy. In fact, lithium can cause sodium depletion, so it's important for clients to maintain adequate salt intake unless otherwise instructed by their healthcare provider.

D. "You will need your blood levels drawn weekly during the first month."

This statement is correct. Monitoring serum lithium levels is crucial to ensure the medication's effectiveness and prevent toxicity. Initially, frequent monitoring is necessary to establish the appropriate dosage and assess for any signs of toxicity. Weekly blood level checks during the first month of therapy are common practice.