A nurse is reviewing the medical history of a client who is to start taking prednisone. Which of the following findings should the nurse identify as a contraindication to prednisone therapy?

A. Insomnia: Pioglitazone is not typically associated with insomnia as an adverse effect.

Insomnia is more commonly associated with stimulant medications or certain medical conditions.
B. Fluid retention: Pioglitazone, a thiazolidinedione, can cause fluid retention as an adverse effect. This can lead to peripheral edema and exacerbation of heart failure, particularly in

susceptible individuals. Monitoring for signs and symptoms of fluid retention, such as peripheral edema and weight gain, is essential.
C. Tinnitus: Tinnitus is not a commonly reported adverse effect of pioglitazone. Tinnitus is more commonly associated with medications such as certain antibiotics, NSAIDs, and ototoxic drugs.
D. Orthostatic hypotension: Orthostatic hypotension is not typically associated with pioglitazone.

It is more commonly associated with medications that affect blood pressure regulation, such as antihypertensives and alpha-blockers.

A. Leg tenderness: Leg tenderness can be a sign of deep vein thrombosis (DVT), a rare but serious complication associated with oral contraceptives. Therefore, the nurse should report this finding immediately for further evaluation and management to prevent complications such as pulmonary embolism.

B. Cramps: Mild cramps are a common side effect of oral contraceptives and do not typically require immediate reporting unless they are severe or persistent.
C. Nausea: Nausea is a common side effect of oral contraceptives, especially during the initial weeks of use. It usually improves over time and does not typically require immediate reporting unless it is severe or persistent.
D. Abdominal bloating: Abdominal bloating is a common side effect of oral contraceptives and is usually mild and self-limiting. It does not typically require immediate reporting unless it is severe or persistent.