The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.

The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril.

Which ACE inhibitors can be given only once per day? Select all that apply

A. Consulting with a pharmacist about scheduling the dose one hour after the client eats:

While it is important to take risedronate on an empty stomach, waiting one hour after eating is insufficient. The recommendation is to take it first thing in the morning, at least 30 minutes before any other food or drink, including milk.

B. Withholding the medication until the client's breakfast tray is available on the unit:

Delaying the administration of risedronate until breakfast may not align with the recommended dosing instructions, which specify taking it in the morning on an empty stomach. Delaying the medication could affect its effectiveness.

C. Assigning unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk:

Providing milk or other beverages with risedronate is not appropriate, as it can interfere with the medication's absorption. Instructing the client to take it with water alone is the correct approach.

The correct action for the nurse to take when the client with osteoporosis asks for a glass of milk to drink with risedronate is:

D. Instruct the client that it is necessary to take nothing but water with the medication.

Explanation: Risedronate is a bisphosphonate medication used to treat osteoporosis. It is essential that it be taken with plain water (typically at least 6-8 ounces) on an empty stomach, preferably in the morning before any food, beverages, or other medications. Consuming other liquids, especially milk or calcium-containing beverages, can interfere with the absorption of the medication. Therefore, instructing the client to take risedronate with water alone is the correct action to ensure its effectiveness.

The over-the-counter medication that the home health nurse should encourage the client with a history of heart failure (HF) to discuss with the healthcare provider to relieve heartburn when lying down after dinner is:

A. Low sodium antacid.

Explanation: Heartburn is a common symptom of gastroesophageal reflux disease (GERD), and it can exacerbate symptoms in individuals with heart failure due to the discomfort and potential fluid retention associated with excessive sodium intake. Low sodium antacids can help relieve heartburn without exacerbating fluid retention, making them a better choice for individuals with heart failure.

B. Diphenhydramine:

Diphenhydramine is an antihistamine commonly used to relieve allergies and may cause drowsiness. It is not indicated for heartburn or GERD symptoms.

C. Acetaminophen:

Acetaminophen is a pain reliever and fever reducer. It is not used to address heartburn or GERD symptoms.

D. Low dose aspirin:

Aspirin is typically used to prevent cardiovascular events in individuals at risk for heart disease but is not used to treat heartburn or GERD symptoms. In fact, aspirin can irritate the stomach lining and potentially worsen heartburn symptoms.