A nurse in a provider’s office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which of the following client information should the nurse identify as a contributing factor to the decrease in the medication’s effectiveness?

Choice A rationale

Initiating a new IV line below an infected site increases the risk of further infection because fluids can carry pathogens downstream into the vascular system, exacerbating inflammation and infection.

Choice B rationale

Discontinuing the infusion immediately halts further irritation and provides an opportunity to evaluate and address the underlying cause, such as phlebitis or infiltration, to prevent complications like infection or thrombophlebitis.

Choice C rationale

Raising the head of the bed has no direct effect on managing localized inflammation or infection at the IV site and does not address the underlying pathology, such as phlebitis or infiltration.

Choice D rationale

Obtaining a culture from the insertion site is unnecessary unless systemic signs of infection, like fever or sepsis, are present; local management is prioritized first to resolve the issue effectively.

Choice A rationale

Taking medication with room temperature water does not alter the pharmacokinetics or pharmacodynamics significantly. It is unlikely to affect the medication's absorption, distribution, metabolism, or therapeutic efficacy.

Choice B rationale

Taking medication five minutes before the prescribed time is too minimal a deviation to impact the drug's pharmacologic action or effectiveness, given usual variability in timing adherence.

Choice C rationale

Receiving an influenza vaccine two weeks prior would not interfere with arthritis medication effectiveness. Vaccination does not typically alter medication metabolism or inflammatory pathways.

Choice D rationale

Recurring bowel inflammation can impair the absorption of medications by disrupting the mucosal lining, altering drug bioavailability, and reducing therapeutic effectiveness, particularly for orally administered medications.