The patient tells the nurse that his friend has been taking valerian for a long period of time and that he isn't feeling so well. The patient asks the nurse what the adverse effects of valerian are. What adverse effect with valerian would the nurse discuss with the patient?

Choice A rationale Valerian is a sedative herb used to treat insomnia and anxiety. It promotes sleep and has a calming effect on the central nervous system. Therefore, insomnia is the opposite of its intended therapeutic effect and would not be considered an adverse effect. Choice B rationale Valerian is not typically associated with causing jaundice or yellow skin. Yellow skin is a symptom of liver dysfunction, which is more commonly associated with certain other herbal supplements. While rare, liver injury is possible with valerian. Choice C rationale Valerian may affect blood clotting and can increase the risk of bleeding. This can manifest as bruising or an increased propensity for bleeding. Patients taking anticoagulants or antiplatelet drugs should be cautioned about this potential interaction. Choice D rationale Valerian is used as a sleep aid and sedative. It does not typically increase appetite. Increased appetite is more often associated with certain psychotropic medications or medical conditions, and it is not a known adverse effect of valerian.