A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

A) Evaluate the client's ability to recognize the urge to defecate: Assessing the client's ability to recognize the urge to defecate is important for promoting independence in toileting. However, this assessment may not directly indicate the need for administering a laxative. It is more relevant for clients who are able to ambulate or have control over their bowel movements.

B) Determine the frequency and consistency of bowel movements: Assessing the frequency and consistency of bowel movements provides valuable information about the client's bowel function and helps determine the need for a laxative. It allows the nurse to establish a baseline and evaluate the effectiveness of interventions. Understanding the client's typical bowel pattern is crucial before administering a laxative to avoid overmedication or potential complications such as diarrhea or fecal impaction.

C) Observe the skin integrity of the client's rectal and sacral areas: Assessing skin integrity in the rectal and sacral areas is crucial for preventing pressure ulcers, especially in bedfast clients. However, it is not directly related to the need for administering a laxative.

D) Assess the client's strength in moving and turning in the bed: While assessing the client's strength and mobility is important for overall care and prevention of complications related to immobility, it may not be directly related to the need for administering a laxative. This assessment is more relevant for preventing complications such as pressure ulcers and maintaining musculoskeletal function.

A) A total calcium level of 5.5 mg/dL (1.4 mmol/L) is critically low, as the normal reference range for total calcium is between 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L). Hypocalcemia can lead to serious complications such as tetany, arrhythmias, and seizures. Before administering methylprednisolone, which can further decrease calcium levels and contribute to osteoporosis, it is essential to notify the healthcare provider to address the client's low calcium level. This may involve correcting the calcium deficiency before proceeding with the administration of the

B) If a healthcare provider orders a calcium supplement for the client, administering it would be appropriate to help correct the hypocalcemia before administering methylprednisolone. However, in the absence of a direct order, the nurse should first notify the healthcare provider to ensure that the client's calcium levels are addressed appropriately before proceeding with any medication that could exacerbate the issue. The priority is to manage the low calcium levels before administering corticosteroids like methylprednisolone.

C) Administering methylprednisolone with a glass of milk may help with calcium absorption; however, this does not directly address the critical issue of hypocalcemia. The nurse must first prioritize notifying the healthcare provider and correcting the calcium imbalance before proceeding with medication administration.

D) Tapering the dose of methylprednisolone is not immediately appropriate based on the low calcium level alone. Methylprednisolone is often tapered to avoid withdrawal symptoms, but the nurse's first priority is to address the client's hypocalcemia, which can have more immediate clinical consequences. The focus should be on stabilizing the calcium level first.