A nurse is preparing to administer a soapsuds enema to an adult client. Which of the following actions should the nurse take?

When reinforcing teaching with a client who has a duodenal ulcer and a new prescription for sucralfate, the nurse should include the following instructions:

"Take the medication on an empty stomach.": Sucralfate is most effective when taken on an empty stomach, usually 1 hour before meals and at bedtime. Taking it with food or other medications may reduce its effectiveness.

"Remain upright for 30 minutes after taking this medication.": To enhance the efficacy of sucralfate, it is important to remain upright for at least 30 minutes after taking the medication. This helps to prevent the medication from being washed away by stomach acid and allows it to form a protective coating over the ulcer.

The following statements are incorrect or not applicable:

"Stop taking this medication if you develop constipation.": Constipation is a common side effect of sucralfate. However, abruptly stopping the medication is not necessary if constipation occurs. The nurse should instruct the client to increase fluid intake, consume a high-fiber diet, and discuss any concerns with the healthcare provider. If constipation becomes severe or persists, the healthcare provider can provide further guidance on managing this side effect.

"Take an antacid at the same time you take this medication.": Sucralfate can interact with antacids and other medications, reducing its effectiveness. It is recommended to take sucralfate at least 2 hours before or after taking antacids or other medications to avoid interference with its absorption.

This statement is incorrect and requires correction because it suggests starting the flow of urine before positioning the collection container, which can result in contamination of the specimen. The correct procedure for collecting a midstream urine specimen involves the following steps:

1. Provide the client with a clean urine specimen container.

2. Instruct the client to cleanse the genital area using a provided towelette or antiseptic wipes, wiping from front to back.

3. Instruct the client to start urinating into the toilet or bedpan.

4. As the urine stream continues, the client should pass the collection container into the stream to collect the midstream specimen.

5. Once an adequate amount of urine has been collected (as per the laboratory's instructions), the client should remove the container from the stream of urine. 6. The client can then complete urinating into the toilet or bedpan.

The other statements made by the newly licensed nurse are correct:

"Use the provided towelette to cleanse the area by moving in a back-and-forth motion": This statement correctly instructs the client to cleanse the genital area before collecting the urine specimen.

"It will be easier to use your nondominant hand to spread the labia": This statement is correct as it suggests using the nondominant hand to facilitate the collection process.

"Remove the specimen container before stopping the stream of urine": This statement is correct as it indicates that the container should be removed before completing urination.