A nurse is caring for a client who has ulcerative colitis and is receiving sulfasalazine. Which of the following findings requires immediate intervention?

A. Add the medications to the enteral feeding bag. Medications should not be mixed with enteral feeding formula as this can alter drug absorption, cause tube clogging, or result in medication interactions. Each medication should be administered separately to ensure proper effectiveness.

B. Check for gastric residual 15 min after administering the medications. Gastric residual volume (GRV) should be checked before medication administration to assess delayed gastric emptying. Checking it after administration is unnecessary and may disrupt medication absorption without clinical benefit.

C. Keep the client's head elevated 15° while administering the medications. The head of the bed should be elevated at least 30–45 degrees, not 15 degrees, to reduce aspiration risk and promote medication passage. Insufficient elevation increases the likelihood of regurgitation and aspiration pneumonia.

D. Flush the tube with 30 ml of water between each medication. Flushing with 30 mL of water between medications prevents tube clogging and ensures each drug is properly delivered. It also minimizes drug interactions by preventing medications from mixing within the tube.

A. Assist the client to a left lateral position. The preferred position for vaginal suppository insertion is the dorsal recumbent (lying on the back with knees bent) or the lithotomy position. The left lateral position is typically used for rectal suppository administration, not vaginal medication insertion.

B. Insert the suppository along the posterior wall of the vaginal canal. The suppository should be inserted along the posterior vaginal wall, as this allows for proper absorption and helps ensure the medication remains in place. The client should be advised to lie down for at least 10-15 minutes after insertion to prevent the suppository from slipping out.

C. Apply a light coating of petroleum jelly to the suppository. Petroleum jelly should never be used as it can interfere with medication absorption and may break down the suppository. If lubrication is needed, a small amount of water-soluble lubricant (e.g., KY Jelly) can be applied to facilitate insertion.

D. Put on sterile gloves before handling the suppository. Clean gloves (not sterile gloves) are sufficient for vaginal suppository administration. The vaginal canal is not a sterile environment, so strict aseptic technique is not required. However, proper hand hygiene and glove use are essential to prevent contamination and infection.