Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's hi’tory includes which problem?

A) Breastfeeding is not recommended while taking this medication: While it’s important for clients to avoid breastfeeding while taking isotretinoin due to potential harm to the infant, the primary concern for a young adult female planning to become pregnant is the risk of teratogenic effects on the fetus. Therefore, while this information is relevant, it’s not the most important consideration in this situation.

B) Do not take multiple vitamins that contain vitamin A while taking this drug: Avoiding excessive intake of vitamin A is essential to prevent toxicity, but it’s not the most critical consideration for a client planning to become pregnant. The main concern is the teratogenic effects of isotretinoin on the fetus.

C) Baseline liver function results must be obtained during therapy: Monitoring liver function is important during isotretinoin therapy to assess for potential hepatotoxicity, but it’s not the most crucial consideration for a client planning to become pregnant. The primary concern is the need to discontinue the medication before conception to prevent fetal exposure.

D) Discontinue this medication one month before attempting to conceive: This is the most important information for the nurse to provide to the client. Isotretinoin is highly teratogenic and can cause severe birth defects if taken during pregnancy. Therefore, it’s essential for the client to discontinue isotretinoin at least one month before attempting to conceive to ensure the drug is cleared from the body and to prevent fetal exposure.

A) A total calcium level of 5.5 mg/dL (1.4 mmol/L) is critically low, as the normal reference range for total calcium is between 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L). Hypocalcemia can lead to serious complications such as tetany, arrhythmias, and seizures. Before administering methylprednisolone, which can further decrease calcium levels and contribute to osteoporosis, it is essential to notify the healthcare provider to address the client's low calcium level. This may involve correcting the calcium deficiency before proceeding with the administration of the

B) If a healthcare provider orders a calcium supplement for the client, administering it would be appropriate to help correct the hypocalcemia before administering methylprednisolone. However, in the absence of a direct order, the nurse should first notify the healthcare provider to ensure that the client's calcium levels are addressed appropriately before proceeding with any medication that could exacerbate the issue. The priority is to manage the low calcium levels before administering corticosteroids like methylprednisolone.

C) Administering methylprednisolone with a glass of milk may help with calcium absorption; however, this does not directly address the critical issue of hypocalcemia. The nurse must first prioritize notifying the healthcare provider and correcting the calcium imbalance before proceeding with medication administration.

D) Tapering the dose of methylprednisolone is not immediately appropriate based on the low calcium level alone. Methylprednisolone is often tapered to avoid withdrawal symptoms, but the nurse's first priority is to address the client's hypocalcemia, which can have more immediate clinical consequences. The focus should be on stabilizing the calcium level first.