A nurse is reinforcing teaching for a client who has rheumatoid arthritis and a new prescription for aspirin 650 mg orally every 6 hr. The nurse should instruct the client to monitor for which of the following adverse effects of aspirin therapy?

A. Insomnia is not a typical adverse effect of aspirin; it is more commonly associated with stimulant medications or corticosteroids. B. Constipation is not expected with aspirin use; in fact, gastrointestinal irritation or bleeding is a greater concern. C. Bleeding is a major adverse effect of aspirin due to its antiplatelet action, which inhibits clot formation. Clients should be taught to monitor for signs such as bruising, nosebleeds, bleeding gums, black or tarry stools, or blood in urine or vomit, and to notify the healthcare provider immediately if these occur. D. Blurred vision may occur with other medications or toxicity, but it is not a primary adverse effect associated with aspirin therapy at therapeutic doses.