A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

Choice A reason: This is the correct action for the nurse to take. Risedronate is a bisphosphonate that is used to treat osteoporosis by inhibiting bone resorption. It should be taken with a full glass of water at least 30 minutes before the first food or drink of the day, as food and beverages can reduce its absorption and effectiveness. Milk and other dairy products are especially problematic, as they contain calcium, which can bind to risedronate and prevent it from reaching the bone.

Choice B reason: This is not a correct action for the nurse to take. Assigning a UAP to bring the client a glass of low fat milk is not appropriate, as it contradicts the instruction to take risedronate with water only. Low fat milk still contains calcium, which can interfere with risedronate absorption. The nurse should educate the client and the UAP about the proper administration of risedronate and the importance of avoiding food and beverages for at least 30 minutes after taking the medication.

Choice C reason: This is not a correct action for the nurse to take. Consulting with a pharmacist about scheduling the dose one hour after the client eats is not necessary, as risedronate should be taken before the first food or drink of the day, not after. Taking risedronate one hour after eating may not ensure adequate absorption and efficacy, as food and beverages can remain in the stomach for longer periods of time. The nurse should follow the prescribed schedule and the manufacturer's guidelines for risedronate administration.

Choice D reason: This is not a correct action for the nurse to take. Withholding the medication until the client's breakfast tray is available on the unit is not advisable, as it may delay the treatment of osteoporosis and increase the risk of fractures. Risedronate should be taken as soon as possible after waking up, before the first food or drink of the day, to maximize its absorption and effectiveness. The nurse should not postpone the medication administration without consulting the healthcare provider.

Choice A reason: Priming the inhaler with 7 pumps is an incorrect action, as it wastes the medication and reduces the number of doses available. The nurse should teach the client that ipratropium inhaler only needs to be primed once when it is first used, or if it has not been used for more than 3 days. To prime the inhaler, the client should spray it into the air away from the face until a fine mist appears.

Choice B reason: Rinsing the mouth after each use is a correct action, as it prevents dry mouth and irritation caused by the medication. Ipratropium is an anticholinergic drug that blocks the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and mucus. The nurse should teach the client to rinse the mouth with water or mouthwash after using the inhaler, and to drink plenty of fluids to stay hydrated.

Choice C reason: Storing the medication at room temperature is a correct action, as it preserves the quality and effectiveness of the medication. The nurse should teach the client to store the ipratropium inhaler at room temperature, away from heat, moisture, and direct sunlight. The nurse should also instruct the client to check the expiration date and the dose counter of the inhaler, and to replace it when it is empty or expired.

Choice D reason: Attaching spacer device to the inhaler is a correct action, as it improves the delivery and absorption of the medication. A spacer is a device that attaches to the mouthpiece of the inhaler and creates a chamber that holds the medication until the client inhales it. The nurse should teach the client to use a spacer with the ipratropium inhaler, as it can reduce the risk of side effects, such as coughing, throat irritation, and hoarseness. The nurse should also teach the client how to clean and maintain the spacer device.