The mother of an adolescent male tells the clinic nurse that she found anabolic steroids in her son's room. How should the nurse respond? Select all that apply.

A. Statins, such as atorvastatin: Statins primarily lower cholesterol and have no significant interaction with sildenafil that would cause an urgent safety concern. Although monitoring for muscle-related side effects is important with statins, it is not the priority here.

B. Analgesics, such as acetaminophen: Acetaminophen is generally safe and does not interact dangerously with sildenafil. There is no immediate concern related to combining these two medications.

C. Anticoagulants, such as warfarin: There is a potential for increased bleeding risk when sildenafil is combined with anticoagulants, but this is generally not an acute, life-threatening interaction requiring immediate determination before other more critical concerns.

D. Nitrates, such as nitroglycerin: Taking sildenafil with nitrates can cause profound, life-threatening hypotension. Both sildenafil and nitrates can cause vasodilation, and their combined use can lead to a dangerous and potentially fatal drop in blood pressure. This combination is absolutely contraindicated, and the nurse must immediately assess whether the client uses any nitrate medication to prevent a serious adverse event.

A. Total bilirubin 4 mg/dL (68.4 μmol/L): Elevated bilirubin suggests possible liver dysfunction or hemolysis but is not directly associated with vitamin D toxicity. Vitamin D overdose primarily leads to disturbances in calcium metabolism rather than bilirubin elevations.

B. Total calcium level 12 mEq/L (3 mmol/L): Hypercalcemia is a hallmark of vitamin D overdose because vitamin D increases calcium absorption from the gastrointestinal tract. A calcium level above the normal range signals potential toxicity that needs immediate attention.

C. Sodium level 140 mEq/L (140 mmol/L): A sodium level of 140 mEq/L falls squarely within the normal reference range. This value does not suggest any connection to vitamin D toxicity or indicate any immediate concern regarding electrolyte imbalance.

D. Serum glucose 170 mg/dL (9.4 mmol/L): Elevated blood glucose may point to uncontrolled diabetes or stress response but is not linked to excessive vitamin D intake. Vitamin D toxicity primarily affects calcium regulation, not glucose metabolism.