A nurse is providing teaching to a client who has a prescription for methylprednisolone. Which of the following findings should the nurse include as an adverse effect of this medication?

Choice A reason: Arterial blood gases are not routinely required before initiating lithium therapy. They are more relevant in respiratory or metabolic disorders, not in baseline monitoring for lithium.

Choice B reason: Total cholesterol is not directly affected by lithium therapy. While metabolic monitoring may be necessary for some psychiatric medications, cholesterol is not a priority baseline test for lithium.

Choice C reason: Thyroid hormones should be evaluated because lithium can interfere with thyroid function, leading to hypothyroidism. Baseline thyroid levels are essential to monitor for potential adverse effects during therapy.

Choice D reason: Hemoglobin levels are not directly impacted by lithium therapy. While general health screening may include hemoglobin, it is not a priority baseline test specific to lithium administration.

Choice A reason: Informing the provider is necessary, but it is not the first action. Before contacting the provider, the nurse must gather immediate data to assess the severity of the client’s condition. Without objective information, communication with the provider may be incomplete or delayed in urgency.

Choice B reason: Obtaining a pulse oximetry reading is the priority because the client is experiencing shortness of breath and chest pain, which may indicate impaired oxygenation. Pulse oximetry provides rapid, non-invasive data about oxygen saturation, guiding immediate interventions. This step ensures that the nurse can quickly determine if supplemental oxygen or emergency measures are required.

Choice C reason: Administering pain medication is important for comfort, but pain management is not the priority when the client shows signs of possible respiratory compromise. Addressing oxygenation and circulation must come before pain relief in acute trauma situations.

Choice D reason: Requesting a chest x-ray is appropriate for diagnostic purposes, but it is not the first action. Imaging takes time and requires physician orders. Immediate assessment of oxygenation is more urgent to stabilize the client before further diagnostics.