A nurse is caring for a client who has a new prescription for alendronate.
Which of the following actions should the nurse take?
Assess the client's ability to swallow.
Administer the medication before bed.
Administer the medication with orange juice.
Inform the client to remain supine after taking the medication.
The Correct Answer is A
Choice A rationale
Alendronate is a bisphosphonate medication used to treat osteoporosis. It is known to be highly irritating to the esophageal mucosa, and if it lodges in the esophagus, it can cause severe esophagitis, ulceration, or erosion. Assessing the client's ability to swallow ensures safe passage of the medication and minimizes the risk of esophageal injury, highlighting a critical safety measure.
Choice B rationale
Alendronate should not be administered before bed. For optimal absorption and to minimize the risk of esophageal irritation, alendronate must be taken in the morning upon waking, at least 30 minutes before the first food, beverage, or medication. Taking it before bed increases the likelihood of the pill lingering in the esophagus, leading to irritation and potential injury.
Choice C rationale
Alendronate should not be administered with orange juice. The absorption of alendronate is significantly impaired by food, beverages other than plain water, and certain minerals like calcium. Orange juice contains calcium and can decrease the bioavailability of the medication, thereby reducing its therapeutic effectiveness. It must be taken with plain water only.
Choice D rationale
Informing the client to remain supine after taking the medication is incorrect. To facilitate rapid transit to the stomach and minimize esophageal contact, clients must remain upright (sitting or standing) for at least 30 minutes after taking alendronate, and until after their first food of the day. Lying down increases the risk of esophageal reflux and irritation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Acyclovir is primarily excreted renally, and its metabolism can lead to crystal formation in the renal tubules, particularly if the client is dehydrated or the infusion is too rapid. Monitoring for an increase in creatinine (normal range 0.6-1.2 mg/dL) is crucial as it indicates decreased glomerular filtration rate and potential nephrotoxicity or acute kidney injury, necessitating dose adjustment or hydration.
Choice B rationale
Administering oxygen prophylactically is not a standard or scientifically indicated action for acyclovir administration. Acyclovir does not inherently cause respiratory depression or compromise oxygenation. Its primary adverse effects are typically related to renal function, central nervous system, or gastrointestinal system, not respiratory compromise.
Choice C rationale
While some antiviral medications can affect hematopoiesis, acyclovir is not commonly associated with significant decreases in hemoglobin (normal range 12-18 g/dL) and hematocrit (normal range 37-52%). These parameters are generally monitored in clients with pre-existing hematological conditions or those on long-term, high-dose therapy, but it's not a primary immediate concern for IV administration.
Choice D rationale
Administering acyclovir IV over 30 minutes is the recommended infusion duration. Rapid intravenous infusion can increase the risk of renal tubular damage and crystal formation, leading to nephrotoxicity. A slower infusion rate allows for proper dilution and minimizes the concentration of the drug in the renal tubules, thus protecting kidney function and reducing adverse effects.
Correct Answer is A
Explanation
Choice A rationale
Somatropin is a synthetic growth hormone used to treat growth hormone deficiency. The primary therapeutic effect of this medication is to promote linear growth in children. Therefore, monitoring the child's height monthly is a direct and quantifiable measure to evaluate the effectiveness of somatropin therapy and ensure that the child is achieving the expected growth velocity.
Choice B rationale
While thyroid function can influence growth, and growth hormone deficiency can sometimes coexist with or impact thyroid axis, evaluating the therapeutic effect of somatropin directly involves assessing growth. Monitoring thyroid function is important for overall endocrine health but is not the primary measure for the therapeutic effect of somatropin itself, assuming thyroid function is within normal limits (e.g., TSH 0.4-4.0 mIU/L, free T4 0.8-1.8 ng/dL).
Choice C rationale
Checking the child's sodium level regularly is not a direct measure of the therapeutic effect of somatropin. Growth hormone can influence fluid balance, but sodium levels (normal range 135-145 mEq/L) are primarily monitored for hydration status or potential adverse effects like fluid retention, not as an indicator of growth hormone's efficacy in promoting growth.
Choice D rationale
Measuring the child's abdominal girth is a measure of abdominal circumference, primarily used to assess abdominal distention, fluid accumulation, or changes in visceral fat. It is not a relevant parameter for evaluating the therapeutic effect of somatropin, which is specifically aimed at stimulating linear bone growth and overall somatic growth.
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