A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?
Ask the client to describe how she takes the medication.
Suggest use of an antacid two hours after the medication.
Remind the client to take the medication with plenty of water.
Advise the client to go to the nearest emergency department.
The Correct Answer is A
A) Asking the client to describe how she takes the medication is the most appropriate initial response by the nurse. “Heartburn” reported after taking risedronate raises concerns about potential esophageal irritation or gastroesophageal reflux disease (GERD) exacerbation. Understanding the client’s administration technique (e.g., whether she takes the medication with a full glass of water and remains upright for at least 30 minutes afterward) can help identify potential causes of the reported symptoms.
B) While suggesting the use of an antacid two hours after the medication may provide symptomatic relief, it does not address the underlying issue of potential esophageal irritation or GERD exacerbation related to risedronate administration. Moreover, if the client’s symptoms are due to esophageal irritation, using an antacid may mask the symptoms without addressing the cause.
C) Reminding the client to take the medication with plenty of water is a standard recommendation for bisphosphonate administration to minimize the risk of esophageal irritation and ensure proper drug absorption. However, since the client is already experiencing “heartburn,” further assessment of the client’s medication administration technique is warranted before providing this reminder.
D) Advising the client to go to the nearest emergency department is not appropriate at this stage, as the reported symptom of “heartburn” does not suggest an immediate life-threatening emergency. However, if the client experiences severe chest pain, difficulty swallowing, or signs of a severe allergic reaction (e.g., swelling of the face or throat, difficulty breathing), emergency medical attention would be necessary.
Therefore, the nurse should first assess the client’s medication administration technique to determine if improper administration may be contributing to the reported symptoms. Based on this assessment, appropriate interventions can be provided to address potential esophageal irritation or GERD exacerbation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Taking ferrous sulfate elixir with a glass of milk is not recommended because milk can interfere with the absorption of iron. Iron absorption is enhanced in an acidic environment, and milk's ca’cium content can inhibit this process.
B) Using a straw to ingest the ferrous sulfate elixir is advisable because it can help minimize contact between the medication and the teeth, reducing the risk of staining. Iron supplements can cause discoloration of the teeth, and using a straw directs the liquid towards the back of the mouth, bypassing the teeth.
C) Swallowing ferrous sulfate elixir undiluted is the usual method of administration; however, doing so may increase the risk of staining the teeth due to direct contact with the oral mucosa and teeth. It is important to follow the healthcare provider's in’tructions regarding dosage and administration.
D) Mixing ferrous sulfate elixir with an antacid is generally not recommended unless specifically directed by the healthcare provider. Antacids containing calcium or magnesium can bind to iron, forming complexes that are poorly absorbed in the gastrointestinal tract, thereby reducing the effectiveness of iron supplementation.
Correct Answer is C
Explanation
A) Tamsulosin is typically administered once daily, not on a twice-weekly dosing schedule. Instructing the client to adhere to the prescribed dosing frequency is essential for maintaining therapeutic blood levels of the medication and optimizing its effectiveness in managing urinary retention associated with benign prostatic hyperplasia (BPH).
B) While the timing of medication administration can impact its effectiveness, taking tamsulosin early in the day versus later in the day may not significantly affect its therapeutic action. The key consideration with tamsulosin is to maintain consistency in timing to ensure a steady plasma concentration of the drug.
C) Instructing the client to stand and sit up slowly is crucial because tamsulosin, as an alpha-blocker, can cause orthostatic hypotension, especially when first starting the medication or when increasing the dosage. By advising the client to change positions slowly, the nurse helps prevent falls and dizziness, which are common side effects associated with sudden drops in blood pressure.
D) Reducing daily fluid intake is not advisable, especially for a client with urinary retention. Maintaining adequate hydration is essential for overall health and urinary function. Tamsulosin works by relaxing the smooth muscles of the prostate and bladder neck, facilitating urine flow, but it does not directly affect fluid intake requirements.
Therefore, the most important instruction for the nurse to provide is to stand and sit up slowly to minimize the risk of orthostatic hypotension and associated complications.
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