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Option A is wrong because serum uric acid level is not the laboratory value that should be monitored periodically when taking allopurinol. Serum uric acid level is the amount of uric acid in the blood, which is a waste product that is produced by the breakdown of purines. Serum uric acid level is usually high in patients with gouty arthritis, which causes inflammation and pain in the joints due to the deposition of uric acid crystals . Allopurinol lowers serum uric acid level by inhibiting xanthine oxidase, which is involved in the metabolism of purines . However, serum uric acid level is not a reliable indicator of allopurinol's effectiveness or toxicity, because it does not reflect the amount of uric acid in the tissues or urine, where it can cause damage or complications . Serum uric acid level may also fluctuate due to various factors such as diet, hydration, renal function, or drug interactions . Therefore, serum uric acid level is not the laboratory value that should be monitored periodically when taking allopurinol.

Option B is wrong because serum potassium level is not the laboratory value that should be monitored periodically when taking allopurinol. Serum potassium level is the amount of potassium in the blood, which is an electrolyte that is essential for the function of nerves, muscles, and heart. Serum potassium level is normally regulated by the kidneys, which excrete excess potassium or retain potassium when needed . Serum potassium level can be affected by various factors such as diet, hydration, acid-base balance, renal function, or drug interactions . Allopurinol does not have a direct effect on serum potassium level, but it may interact with some drugs that can alter serum potassium level, such as diuretics, angiotensin-converting enzyme inhibitors, or potassium supplements . However, these drug interactions are not specific to allopurinol and can occur with any drug that affects renal function or electrolyte balance . Therefore, serum potassium level is not the laboratory value that should be monitored periodically when taking allopurinol.

Option D is wrong because serum calcium level is not the laboratory value that should be monitored periodically when taking allopurinol. Serum calcium level is the amount of calcium in the blood, which is a mineral that is involved in various processes such as bone formation, muscle contraction, nerve transmission, and blood clotting. Serum calcium level is normally regulated by the parathyroid glands, which secrete parathyroid hormone (PTH) to increase calcium absorption from the gut and bone resorption from the skeleton . Serum calcium level can be affected by various factors such as diet, hydration, vitamin D status, renal function, or drug interactions . Allopurinol does not have a direct effect on serum calcium level, but it may interact with some drugs that can alter serum calcium level, such as thiazide diuretics, which can increase calcium reabsorption in the kidney and cause hypercalcemia . However, these drug interactions are not specific to allopurinol and can occur with any drug that affects renal function or calcium metabolism . Therefore, serum calcium level is not the laboratory value that should be monitored periodically when taking allopurinol.

Option A is wrong because the client should not take prednisone every other day to prevent side effects. Prednisone should be taken as prescribed by the provider, usually once or twice daily with food or milk to prevent gastrointestinal irritation . Prednisone should not be taken every other day or on an irregular schedule, because this can cause fluctuations in blood levels and increase the risk of adverse effects or suboptimal response . Prednisone should also not be stopped abruptly, because this can cause withdrawal symptoms such as fatigue, weakness, nausea, vomiting, or hypotension due to adrenal insufficiency . Prednisone should be tapered gradually under the supervision of the provider to allow the adrenal glands to resume normal cortisol production .

Option B is wrong because the client should not stop taking prednisone if they develop indigestion. Indigestion is a common side effect of prednisone that can be caused by irritation or ulceration of the gastric mucosa due to increased acid secretion and decreased mucus production . The client should not stop taking prednisone without consulting with the provider, because this can cause withdrawal symptoms or worsen their condition . The client should take prednisone with food or milk to reduce gastric irritation and report any severe or persistent indigestion to the provider . The provider may prescribe antacids, histamine-2 blockers, or proton pump inhibitors to protect the stomach lining and prevent bleeding or perforation .

Option C is wrong because the client does not need to increase their intake of foods that are high in potassium. Potassium is an electrolyte that is essential for the function of nerves, muscles, and heart. Potassium levels are normally regulated by the kidneys, which excrete excess potassium or retain potassium when needed . Prednisone does not have a significant effect on potassium levels, unlike mineralocorticoids such as aldosterone, which promote sodium reabsorption and potassium excretion in the kidney . Prednisone may interact with some drugs that can alter potassium levels, such as diuretics, angiotensin-converting enzyme inhibitors, or potassium supplements . However, these drug interactions are not specific to prednisone and can occur with any drug that affects renal function or electrolyte balance . The client should have their potassium levels monitored periodically and follow a balanced diet that meets their nutritional needs . The client should not increase their intake of foods that are high in potassium without consulting with the provider, because this can cause hyperkalemia , which can lead to cardiac arrhythmias or cardiac arrest .

Option A is wrong because the client should not take celecoxib with grapefruit juice to enhance its absorption. Grapefruit juice can interact with celecoxib and increase its blood levels and toxicity . Grapefruit juice inhibits the enzyme CYP3A4, which is involved in the metabolism of celecoxib . By inhibiting CYP3A4, grapefruit juice reduces the clearance of celecoxib and increases its bioavailability and half-life . This can lead to overdose or adverse effects such as gastrointestinal bleeding, renal impairment, or liver damage . The client should avoid grapefruit juice and other foods or drinks that can affect the metabolism of celecoxib .

Option C is wrong because the client should not take celecoxib on an empty stomach to avoid nausea. Nausea is a common side effect of celecoxib that can be caused by irritation or ulceration of the gastric mucosa due to decreased mucus production and increased acid secretion . The client should not take celecoxib on an empty stomach, because this can worsen gastric irritation and increase the risk of bleeding or perforation . The client should take celecoxib with food or milk to reduce gastric irritation and report any severe or persistent nausea to the provider . The provider may prescribe antacids, histamine-2 blockers, or proton pump inhibitors to protect the stomach lining and prevent bleeding or perforation .

Option D is wrong because the client should not stop taking celecoxib if they develop a rash or itching. Rash or itching are possible signs of hypersensitivity or allergic reaction to celecoxib , which can be serious or life-threatening. The client should not stop taking celecoxib without consulting with the provider, because this can cause withdrawal symptoms or worsen their condition . The client should monitor for signs of hypersensitivity or allergic reaction such as rash, itching, hives, swelling, difficulty breathing, or anaphylaxis , and report them to the provider as soon as possible . The provider may prescribe antihistamines or corticosteroids to treat the reaction or discontinue celecoxib and switch to another drug.

Give enteric-coated or buffered aspirin to reduce gastric irritation: Enteric-coated aspirin is designed to resist dissolving and being absorbed in the stomach, so it passes into the small intestine, where it’s absorbed into the bloodstream. The goal is to prevent stomach ulcers and bleeding that can sometimes occur with aspirin use. However, research indicates that enteric-coated aspirin may not be as effective as regular aspirin at reducing blood clot risk. Also, the gastrointestinal benefit of enteric-coated aspirin is minimal to nonexistent. When it comes to rates of ulceration and bleeding, there’s no difference between enteric-coated and regular aspirin¹.

Give aspirin with an antacid to neutralize gastric acid: While antacids can help reduce heartburn and upset stomach that aspirin may cause, they do not prevent the formation of ulcers. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding, including in the stomach and gastrointestinal tract (digestive tract)⁵.

Give aspirin with food or milk to decrease gastric absorption: Taking aspirin with food or milk can help reduce stomach irritation caused by aspirin⁷. However, this does not prevent the formation of ulcers in people with a history of peptic ulcer disease.