A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

Choice A reason: You should avoid alcohol intake while taking codeine, not limit it to 12 ounces daily. Alcohol can increase the risk of side effects such as drowsiness, dizziness, and respiratory depression.

Choice B reason: You should not expect to experience diarrhea while taking codeine. Codeine can cause constipation, not diarrhea. You should increase your fluid and fiber intake and use laxatives as prescribed to prevent constipation.

Choice C reason: You should not take the medication on an empty stomach to prevent nausea. Codeine can cause nausea and vomiting, especially on an empty stomach. You should take the medication with food or milk to reduce nausea.

Choice D reason: You should change positions slowly while taking codeine. Codeine can cause orthostatic hypotension, which is a sudden drop in blood pressure when you stand up. This can cause dizziness, fainting, and falls. You should change positions slowly and use caution when walking or climbing stairs.

Choice A reason: A 32-year-old client who has benign breast disease does not have a contraindication for receiving oral contraceptives. Benign breast disease is not associated with an increased risk of breast cancer or thromboembolic events. However, the nurse should advise the client to perform regular breast self-examinations and report any changes.

Choice B reason: A 26-year-old client who has migraine headaches at the start of each menstrual cycle does not have a contraindication for receiving oral contraceptives. Migraine headaches that are related to the menstrual cycle may actually improve with oral contraceptives, as they can regulate the hormonal fluctuations. However, the nurse should monitor the client for any signs of stroke or hypertension, as these are rare but serious complications of oral contraceptives.

Choice C reason: A 28-year-old client who has a history of pelvic inflammatory disease does not have a contraindication for receiving oral contraceptives. Pelvic inflammatory disease is an infection of the reproductive organs that can cause infertility, chronic pain, and ectopic pregnancy. Oral contraceptives can reduce the risk of pelvic inflammatory disease by creating a thick cervical mucus that prevents the entry of bacteria. However, the nurse should remind the client that oral contraceptives do not protect against sexually transmitted infections, and that barrier methods should be used in addition.

Choice D reason: A 38-year-old client who reports smoking one pack of cigarettes every day has a contraindication for receiving oral contraceptives. Smoking increases the risk of cardiovascular diseases, such as myocardial infarction, stroke, and peripheral vascular disease. Oral contraceptives also increase the risk of these diseases, especially in women older than 35 years. Therefore, the combination of smoking and oral contraceptives can have a synergistic effect and cause serious harm. The nurse should recommend other methods of contraception for this client, such as intrauterine devices, implants, or injections.