A nurse is planning care for a client who has a peptic ulcer and a new prescription for sucralfate 2 gm administered twice daily. Which of the following times should the nurse plan to administer the medication?
One hour before breakfast and the evening meal
At the time the client takes a proton pump inhibitor
Thirty minutes after breakfast and the evening meal
The time the client takes an antacid
The Correct Answer is A
Sucralfate is a medication used to treat peptic ulcers by forming a protective coating on the stomach lining. It should be taken on an empty stomach, as food can interfere with its absorption and effectiveness. One hour before breakfast and the evening meal is the correct timing for administering sucralfate, allowing for an empty stomach before meals.
At the time the client takes a proton pump inhibitor: Proton pump inhibitors are a different class of medications used to reduce stomach acid production. It is recommended to administer sucralfate separately, as it works differently and has different administration requirements.
Thirty minutes after breakfast and the evening meal: Administering sucralfate after meals is not ideal, as it may not provide the desired therapeutic effect on an empty stomach.
The time the client takes an antacid: Antacids are also different from sucralfate, and they can interfere with its absorption. It is generally recommended to administer sucralfate separately from antacids.
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Correct Answer is B
Explanation
Sucralfate is a medication commonly used in the treatment of peptic ulcer disease. It works by forming a protective barrier over the ulcer site, providing a physical barrier against gastric acid, and promoting the healing process. When teaching a client about sucralfate, it is important to provide instructions regarding its proper administration.
One of the key instructions is to take sucralfate 1 hour before meals. This timing allows the medication to form a protective coating in the stomach before food is ingested. Taking sucralfate on an empty stomach enhances its effectiveness in protecting the ulcer and promoting healing.
"Take the medication with an antacid" - Sucralfate should not be taken with an antacid. Antacids can interfere with the protective mechanism of sucralfate by neutralizing stomach acid, which is necessary for sucralfate to bind and form a protective coating. It is recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid.
"Take as needed for pain relief" - Sucralfate is not typically used for immediate pain relief in peptic ulcer disease. It is primarily used for its protective and healing properties. Pain relief is
usually addressed with other medications, such as antacids, acid-reducing medications, or pain medications as prescribed by a healthcare provider.
"Store the medication in the refrigerator" - Sucralfate does not require refrigeration. It should be stored at room temperature, away from excessive heat or moisture, as per the specific instructions provided by the manufacturer or healthcare provider.

Correct Answer is A
Explanation
Elevating the head of the bed can help reduce the symptoms of GERD during sleep. By elevating the head, gravity can help prevent stomach acid from flowing back into the esophagus, reducing the occurrence of reflux.
The other statements do not demonstrate an understanding of the teaching: "I will sleep on my stomach with my head flat": Sleeping on the stomach can actually worsen the symptoms of GERD as it can increase the likelihood of stomach acid flowing back into the esophagus. It is generally recommended to sleep on the left side or back to minimize reflux.
"I will have a snack 1 hour before going to bed": Consuming a snack close to bedtime can increase the likelihood of reflux during sleep. It is generally recommended to avoid eating at least 2 to 3 hours before lying down to minimize reflux symptoms.
"I can have 6 ounces of alcohol before bed, to help me sleep": Alcohol can relax the lower esophageal sphincter (LES) and increase the risk of reflux. It is best to avoid alcohol before bedtime, especially for individuals with GERD.
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