A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Choice A reason: Suggesting the use of an antacid two hours after taking risedronate is not the best initial response. While antacids can help with heartburn, they can also interfere with the absorption of risedronate if taken too close to the medication. It is more important to first understand how the client is taking the medication to ensure proper administration.

Choice B reason: Reminding the client to take the medication with plenty of water is good advice, as risedronate should be taken with a full glass of water to prevent esophageal irritation. However, this response does not address the immediate concern of increasing heartburn. Understanding the client’s current administration method is crucial.

Choice C reason: Asking the client to describe how she takes the medication is the most appropriate response. This allows the nurse to identify any potential issues with the administration technique, such as not taking the medication with enough water or not remaining upright for at least 30 minutes after taking it. Correcting these issues can help reduce heartburn and improve the medication’s effectiveness.

Choice D reason: Advising the client to go to the nearest emergency department is not necessary unless the heartburn is severe or accompanied by other symptoms such as chest pain or difficulty swallowing. Initially, it is more appropriate to assess the client’s administration technique and provide guidance on proper medication use.

Choice A reason:

A CT scan performed six months earlier does not typically require follow-up unless there were specific findings or complications from the previous scan. The timing of the previous scan is not a contraindication for a new CT scan with contrast. However, it is always good practice to review previous imaging results to compare and assess any changes.

Choice B reason:

Metformin hydrochloride is a medication used to manage type 2 diabetes mellitus. It is important to follow up on this information because metformin can interact with the contrast dye used in CT scans. The combination can increase the risk of lactic acidosis, a rare but serious complication. Therefore, it is crucial to assess kidney function and possibly withhold metformin before and after the procedure to reduce this risk.

Choice C reason:

A report of the client’s sobriety for the last five years is generally a positive aspect of their medical history and does not require follow-up in the context of a CT scan with contrast. Sobriety does not impact the safety or efficacy of the contrast dye used in the scan.

Choice D reason:

A metal hip prosthesis placed twenty years ago is relevant information but does not typically require follow-up before a CT scan. Unlike MRI, where metal implants can cause issues, CT scans are generally safe for patients with metal prostheses. However, the presence of metal can sometimes affect the quality of the images, so it is important for the radiologist to be aware of it.