A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?

Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.

Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.

Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.

Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.

Choice A reason: Decreases inflammation is a therapeutic effect of prednisone. Prednisone is a corticosteroid that suppresses the immune system and reduces the production of inflammatory mediators. This helps to relieve the pain, swelling, and stiffness of rheumatoid arthritis.

Choice B reason: Increases bone density is not a therapeutic effect of prednisone. Prednisone can cause bone loss and osteoporosis by decreasing calcium absorption and increasing calcium excretion. This increases the risk of fractures and bone damage.

Choice C reason: Reduces risk of infection is not a therapeutic effect of prednisone. Prednisone can increase the risk of infection by weakening the immune system and making it less able to fight off pathogens. This requires close monitoring and prophylactic antibiotics.

Choice D reason: Improves peripheral blood flow is not a therapeutic effect of prednisone. Prednisone can impair peripheral blood flow by causing vasoconstriction and increasing blood pressure. This can worsen the symptoms of peripheral vascular disease and increase the risk of thrombosis.