A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

A. Pedal edema
Explanation: Pedal edema (swelling of the feet) is not a typical sign of an acute infusion reaction to IV amphotericin B.
B. Fever
Explanation: Fever is a common sign of an acute infusion reaction, indicating an inflammatory response to the medication.
An acute infusion reaction to IV amphotericin B is most commonly characterized by fever and chills, as well as other flu-like symptoms such as headache, muscle or joint pain, and sometimes a dry cough. Fever is a key indicator of an acute reaction to amphotericin B, and the presence of fever during or after administration should raise concern and prompt the nurse to take appropriate action, including notifying the healthcare provider and discontinuing the infusion.
Pedal edema and hyperglycemia are not typically associated with acute infusion reactions to amphotericin B and are not common manifestations of this type of reaction.
C. Hyperglycemia
Explanation: Hyperglycemia (high blood sugar) is not typically associated with an acute infusion reaction to IV amphotericin B.
D. Dry cough
Explanation: A dry cough can be a symptom of an acute infusion reaction, potentially indicating irritation or inflammation of the respiratory tract.

A. Correct Answer: St. John's Wort
Explanation: The nurse should advise the client to avoid taking St. John's Wort. St. John's Wort is an herbal supplement commonly used to treat depression and anxiety. However, it can have significant interactions with various medications, including sertraline. Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. St. John's Wort can increase serotonin levels in the brain, and when combined with medications that also affect serotonin levels (such as sertraline), it can lead to a potentially dangerous condition known as serotonin syndrome. Therefore, it's important to avoid St. John's Wort while taking sertraline to prevent adverse effects and interactions.
B. Incorrect Explanation: Coenzyme Q10
Explanation: Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that plays a role in energy production within cells. While CoQ10 is generally considered safe, it does not have known interactions with sertraline. Therefore, the nurse would not necessarily advise the client to avoid CoQ10 solely based on its potential interaction with sertraline.
C. Incorrect Explanation: Black Cohosh
Explanation: Black cohosh is an herbal supplement often used to manage symptoms of menopause. It is not typically known to have significant interactions with sertraline. However, it's important for the client to discuss any supplements with their healthcare provider before starting them, especially when taking prescribed medications. The nurse might not necessarily advise the client to avoid black cohosh unless there are specific concerns based on the client's medical history.
D. Incorrect Explanation: Ginger Root
Explanation: Ginger root is a commonly used spice and herbal remedy. It does not have known interactions with sertraline and is generally considered safe for most people. However, as with any supplement, it's a good practice to consult with a healthcare provider before starting it, especially when taking prescribed medications like sertraline. The nurse would not necessarily advise the client to avoid ginger root without specific reasons related to the client's health.