Which instruction should the nurse provide to the client with diabetes mellitus receiving acarbose (Precose)? Select all that apply.

Take the medication with each meal.”
Side effects include abdominal bloating and flatus.”
Take some form of glucose if hypoglycemia occurs.”
Report symptoms such as shortness of breath or tiredness.”

The mechanism of action of acarbose is a delay in absorption of dietary carbohydrates. thereby reducing the rise in blood glucose after a meal. To accomplish this. the medication must be taken with each meal. Because of its bacterial fermentation of unabsorbed carbohydrates in the colon. side effects such as borborygmus. cramps. abdominal distention. and flatulence can occur. The medication also can affect absorption of iron. leading to symptoms (shortness of breath. tiredness) of anemia.