The client is prescribed valproic acid for a new diagnosis of epilepsy. The nurse will include the following instructions in medication education to the client. Select all that apply.

A. Take the drug with food if gastric irritation occurs: Valproic acid can cause gastrointestinal upset including nausea and indigestion. Taking the medication with food helps minimize gastric irritation and improves tolerance without reducing its effectiveness. B. Frequent monitoring of liver function tests and complete blood count: Valproic acid carries a risk of hepatotoxicity and bone marrow suppression. Regular monitoring of liver enzymes and CBC is essential to detect adverse effects early and ensure the client’s safety. C. Frequent monitoring of therapeutic serum levels: Valproic acid has a defined therapeutic range that must be maintained for effective seizure control. Regular monitoring helps avoid subtherapeutic levels that risk seizures and toxic levels that can cause adverse effects. D. Frequent monitoring of serum creatinine levels: Serum creatinine primarily assesses renal function. Valproic acid is metabolized in the liver rather than the kidneys, so monitoring renal function is not the main focus unless other comorbidities are present. E. Counseling for women of childbearing age who wish to become pregnant: Valproic acid is teratogenic and associated with neural tube defects and developmental disorders. Women of reproductive age need counseling about risks, alternative therapies, and the importance of contraception or preconception planning. F. Crush the medication if you have difficulty swallowing: Crushing valproic acid tablets, especially extended-release formulations, alters drug absorption and increases the risk of toxicity. Clients should not crush or chew the tablets.