Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client’s history includes which problem?

 

Choice A reason: Assessing the client’s strength in moving and turning in bed is important for overall care, but it is not the primary assessment needed before administering a laxative. This assessment helps in understanding the client’s mobility and risk of pressure ulcers but does not directly relate to the effectiveness or necessity of a laxative.

Choice B reason: Determining the frequency and consistency of bowel movements is crucial before administering a laxative. This assessment provides information on the client’s current bowel function and helps in deciding the appropriate type and dosage of laxative. It ensures that the laxative is necessary and helps prevent complications such as diarrhea or bowel obstruction.

Choice C reason: Observing the skin integrity of the client’s rectal and sacral areas is important for preventing pressure ulcers and maintaining skin health, especially in bedfast clients. However, this assessment is not directly related to the administration of a laxative. It is more relevant to overall skin care and prevention of pressure sores.

Choice D reason: Evaluating the client’s ability to recognize the urge to defecate is important for understanding their bowel habits and potential issues with incontinence. However, it is not the primary assessment needed before administering a laxative. This assessment is more relevant to managing bowel training and incontinence.

Choice A Reason:

Notifying the healthcare provider of the contraindication to tetracyclines is not necessary in this context. Doxycycline, a type of tetracycline, is commonly prescribed and does not have a direct contraindication with birth control pills. However, the nurse should be aware of potential interactions and advise the client accordingly.

Choice B Reason:

Advising the client that the birth control pills will be less effective while taking doxycycline hyclate is crucial. Antibiotics like doxycycline can reduce the effectiveness of hormonal contraceptives, increasing the risk of unintended pregnancy. The client should be informed about this interaction and advised to use an additional non-hormonal method of contraception, such as condoms, while taking the antibiotic and for a short period after completing the course.

Choice C Reason:

Instructing the client to take the two medications at least two hours apart is not relevant in this case. The interaction between doxycycline and birth control pills is not related to the timing of administration but rather to the potential reduction in the effectiveness of the contraceptive.

Choice D Reason:

Encouraging the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate is not advisable. Stopping birth control pills can lead to a disruption in the contraceptive regimen and increase the risk of unintended pregnancy. Instead, the client should be advised to use an additional method of contraception.