During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?

Choice A reason: This is incorrect because withholding all medications may cause hyperglycemia or ketoacidosis in the patient, especially if they are taking insulin or sulfonylureas. The nurse should consult with the prescriber to adjust the dose or timing of the medications according to the patient's blood glucose level and the duration of the procedure.

Choice B reason: This is correct because contacting the prescriber to clarify orders is the best action by the nurse, as the prescriber can provide specific instructions on how to manage the patient's oral antidiabetic drugs before and after the oral endoscopy. The nurse should also monitor the patient's blood glucose level closely and report any abnormal findings to the prescriber.

Choice C reason: This is incorrect because administering half the original dose may not be appropriate for the patient, as it may cause hypoglycemia or hyperglycemia depending on the type and dose of the medication and the patient's blood glucose level. The nurse should not make any changes to the medication regimen without the prescriber's approval.

Choice D reason: This is incorrect because giving the medication with a sip of water may violate the NPO status of the patient, which is necessary to prevent aspiration or interference with the oral endoscopy. The nurse should not administer any oral medications or fluids to the patient unless the prescriber allows it.

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.