A patient is being discharged on a home course of antibiotics.

What education should the nurse provide as an effective way to prevent antibiotic resistance?

Choice A rationale
Tuberculous meningitis is a serious condition, but it is not a contraindication for the use of prednisone.
Choice B rationale
Chronic obstructive pulmonary disease (COPD) is not a contraindication for prednisone. In fact, prednisone is often used to treat exacerbations of COPD56.
Choice C rationale
Cerebral edema is not a contraindication for prednisone. Prednisone is sometimes used to reduce inflammation and swelling in the brain.
Choice D rationale
Peptic ulcer disease is a contraindication for the use of prednisone. Prednisone can increase the risk of peptic ulcers by increasing stomach acid secretion and decreasing the production of protective mucus in the stomach.

Choice A rationale
A client with a hip fracture and is on bedrest for 4 weeks may indeed experience constipation due to decreased physical activity. However, this situation would not necessarily require the nurse to question the order for psyllium. Psyllium is a bulk-forming laxative that can help relieve constipation by increasing stool bulk and improving bowel regularity.
Choice B rationale
Morphine is an opioid medication that can cause constipation as a side effect. Therefore, a client who is experiencing severe pain and is prescribed morphine may benefit from a laxative like psyllium to help manage opioid-induced constipation. This situation would not necessarily require the nurse to question the order for psyllium.
Choice C rationale
A client who is post-operative and is on a clear liquid diet may experience constipation due to the low fiber content of the diet. However, this situation would not necessarily require the nurse to question the order for psyllium. Once the client progresses to a regular diet, psyllium can help add bulk to the stool and promote regular bowel movements.
Choice D rationale
This choice is correct. A client with a recent stroke who has difficulty swallowing may be at risk for aspiration, or the inhalation of food or liquid into the lungs, when taking psyllium. Psyllium is a bulk-forming laxative that absorbs water in the intestines to form a softer, bulkier stool. If a client with swallowing difficulties were to aspirate the psyllium, it could potentially expand in the lungs when it comes into contact with moisture, leading to serious complications. Therefore, the nurse should question the order for psyllium in this situation.