A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A. Maintain the head of the bed in a flat position for 30 min following medication administration: This option is incorrect because after administering medications through an NG tube, it's crucial to elevate the head of the bed to at least 30 to 45 degrees to minimize the risk of aspiration. Keeping the head of the bed flat increases the likelihood of reflux and aspiration of medication.
B. Mix the three medications together prior to administering: This option is incorrect because mixing medications without specific instructions from the healthcare provider can lead to potential interactions or alterations in the effectiveness of the drugs. Each medication should be administered separately to ensure accurate dosing and prevent potential adverse effects.
C. Rush the NG feeding tube with 30 mL of water immediately: This option is incorrect because while flushing the NG tube with water after medication administration is necessary to ensure that the medications reach the stomach and to prevent tube occlusion, the recommended volume for flushing is typically 30 to 60 mL, not just 30 mL. Using a larger volume of water helps ensure thorough flushing of the tube.
D. Dilute each medication with 10 mL of tap water: This is the correct action. Diluting each medication with 10 mL of tap water is a standard practice to ensure proper administration through an NG tube. Dilution helps prevent tube occlusion and irritation of the gastric mucosa, reducing the risk of complications such as clogging of the tube or local irritation. Additionally, diluting the medications facilitates their passage through the tube and into the stomach, optimizing absorption and effectiveness while minimizing the risk of adverse effects.

A. Pancrelipase 500 units/kg PO three times daily with meals: Pancrelipase is an enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates in clients with pancreatic insufficiency. However, in acute pancreatitis, the pancreas is inflamed and typically unable to produce sufficient enzymes. Therefore, enzyme replacement therapy is not typically initiated during the acute phase of pancreatitis.
B. Pantoprazole 80 mg IV bolus twice daily: This is the correct answer. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion. It is commonly prescribed in acute pancreatitis to decrease gastric acid production and reduce pancreatic enzyme activity, thereby promoting pancreatic rest and reducing further pancreatic inflammation and injury.
C. Initiate a low-residue diet: In acute pancreatitis, clients are typically kept NPO (nothing by mouth) initially to allow the pancreas to rest and inflammation to decrease. Once oral intake is resumed, a low-fat, easily digestible diet is usually recommended. However, the initiation of a low-residue diet is not typically indicated during the acute phase of pancreatitis.
D. Ambulate twice daily: While early ambulation is generally encouraged in hospitalized clients to prevent complications such as deep vein thrombosis and pneumonia, ambulation may be limited initially in clients with acute pancreatitis due to pain and discomfort. Ambulation is not typically a priority during the acute phase of pancreatitis; instead, pain management and supportive care are emphasized.