A nurse is teaching a client who has a new prescription for tetracycline.
Which of the following information should the nurse include in the teaching?

Choice A rationale

Tetracycline binds to divalent and trivalent cations such as calcium, magnesium, and aluminum. Milk and dairy products are rich in calcium, so taking tetracycline with milk significantly reduces its absorption from the gastrointestinal tract, rendering the medication less effective. The drug should be taken on an empty stomach with a full glass of water.

Choice B rationale

Taking tetracycline at bedtime is not a recommended practice for this drug. Although some medications are taken at night to avoid side effects or promote sleep, tetracycline can cause gastroesophageal reflux or esophagitis, particularly when a person lies down soon after ingestion. It is important to remain upright for at least 30 minutes after taking the medication.

Choice C rationale

Photosensitivity is a well-documented adverse effect of tetracycline. The drug sensitizes the skin to ultraviolet light, leading to an exaggerated sunburn reaction. This is due to the drug's accumulation in the skin and its ability to absorb light energy. Clients must be advised to use sunscreen, wear protective clothing, and avoid prolonged sun exposure.

Choice D rationale

Tetracycline is known to cause gastrointestinal side effects, but diarrhea is far more common than constipation. This is often due to the disruption of the normal gut flora, which can lead to opportunistic infections like Clostridium difficile. While not exclusively causing diarrhea, constipation is not a typical adverse effect and should not be the primary teaching point. *.

Choice A rationale

Sitting in chairs with low, soft backs can worsen osteoarthritis symptoms and increase joint stress. Low chairs require more force from the hips and knees to stand up, which can strain these joints. Soft backs provide inadequate support, leading to poor posture and increased stress on the spine and other joints. Proper joint protection involves maintaining good posture and minimizing strain on affected joints.

Choice B rationale

Using both hands to hold objects distributes the weight and stress evenly across multiple joints, such as those in both wrists and hands, thereby reducing the workload on any single joint. This technique minimizes the risk of joint deformation and pain associated with osteoarthritis by preventing excessive force from being applied to a single joint, a key principle of joint protection.

Choice C rationale

Pushing up from a bed with fingers puts a concentrated, high-impact force on the small joints of the fingers, which are often affected by osteoarthritis. This action can lead to pain, inflammation, and potential deformity over time. Instead, individuals should use their palms or forearms to push up, distributing the force over a larger, stronger surface area.

Choice D rationale

Turning doorknobs clockwise or in any specific direction with a forceful grip can exacerbate joint pain and strain in the fingers and wrist. This motion places significant torque on the affected joints. To protect joints, clients should be advised to use lever-style doorknobs or adaptive devices that require less grip strength and a different motion. *.