The nurse is providing client education for a postmenopausal client; which risks associated with estrogen/progestin therapy should the nurse discuss with the client? (Select all that apply.)

Rationale for A: Ibuprofen is generally considered safe for use while breastfeeding, as it passes into breast milk in small amounts that are not expected to harm the infant.

Rationale for B: Lithium can have serious effects on a breastfeeding infant, as it can cause lethargy and developmental issues. Its use is generally not recommended during breastfeeding.

Rationale for C: Methotrexate is contraindicated during breastfeeding due to its potential toxicity and harmful effects on the infant, including possible effects on growth and development.

Rationale for D: Nicotine is harmful to infants and can affect their development. Smoking or using nicotine products while breastfeeding is discouraged due to the associated risks.

A) Hold metformin 24 hours to 48 hours before the CT. This is correct because it reduces the chance of metformin accumulating in the blood and causing lactic acidosis when combined with the contrast dye.

B) Hold metformin 48 hours after the CT. This is also correct because it allows time for the contrast dye to be eliminated from the body before resuming metformin.

C) Double the metformin dose after the CT. This is incorrect and dangerous because it can cause hypoglycemia, low blood sugar, which can lead to confusion, seizures, coma, or death. D) Take metformin as scheduled the day of the CT. This is incorrect and risky because it can result in high levels of metformin in the blood when mixed with the contrast dye, increasing the likelihood of lactic acidosis.

E) Resume metformin at half dose after the CT. This is incorrect and unnecessary because there is no evidence that reducing the dose of metformin after a CT scan with contrast dye has any benefit or reduces any harm.