A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching? Select all that apply.

A. Monitor weight: Pioglitazone can cause fluid retention, which may lead to weight gain and worsen heart failure in susceptible clients. Monitoring weight regularly helps identify early signs of fluid accumulation or edema. B. Anticipate urine to be darkened: Dark urine is not a common or expected effect of pioglitazone. Instead, dark urine may signal liver dysfunction, which requires prompt evaluation, making this instruction inappropriate for routine teaching. C. Assess liver function tests: Pioglitazone is metabolized by the liver and can cause hepatotoxicity. Baseline and periodic monitoring of liver function tests are necessary to ensure safe continuation of therapy. D. Premenopausal women can take this medication while pregnant safely: Pioglitazone is contraindicated in pregnancy due to potential fetal risks. Women of childbearing age should use effective contraception while taking this medication. E. Annual eye exams: Pioglitazone can increase the risk of macular edema, which affects vision. Annual ophthalmologic examinations are recommended to detect early changes and prevent complications.