A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Choice A reason: Tachycardia is a possible adverse effect of theophylline, as it is a methylxanthine that stimulates the central nervous system and the cardiac muscle. The nurse should instruct the client to monitor their pulse rate and report any palpitations, chest pain, or irregular heartbeat.

Choice B reason: Drowsiness is not a likely adverse effect of theophylline, as it is a stimulant that increases alertness and energy. The nurse should caution the client to avoid taking the medication close to bedtime, as it may cause insomnia.

Choice C reason: Constipation is not a common adverse effect of theophylline, as it does not affect the gastrointestinal motility or secretion. The nurse should advise the client to maintain a balanced diet, adequate fluid intake, and regular exercise to prevent constipation.

Choice D reason: Oliguria is not a typical adverse effect of theophylline, as it does not impair the renal function or cause fluid retention. The nurse should encourage the client to drink enough fluids to prevent dehydration and maintain a normal urine output.

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.