A 17-year-old pregnant female in her first trimester presents with symptoms of allergic rhinitis. The nurse practitioner should NOT recommend:

Rationale: A. Cetirizine (Zyrtec) is a second-generation antihistamine considered safe for use in pregnancy, particularly after the first trimester. B. Diphenhydramine (Benadryl) is a first-generation antihistamine generally regarded as safe in pregnancy. C. Loratadine (Claritin) is also considered safe during pregnancy and commonly used for allergic rhinitis. D. Pseudoephedrine (Sudafed) is a decongestant that should be avoided, especially in the first trimester, because it can reduce uteroplacental blood flow and has been associated with a small risk of congenital malformations.