The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

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

Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.

Withhold the medication until the client's breakfast tray is available on the unit.

Consult with a pharmacist about scheduling the dose one hour after the client eats.

Answer and Explanation

The Correct Answer is A

Choice A reason: Risedronate is a bisphosphonate that is used to treat osteoporosis by inhibiting bone resorption. It should be taken on an empty stomach with a full glass of water at least 30 minutes before any other food, beverage, or medication. This is because food, milk, and antacids can interfere with the absorption of risedronate and reduce its effectiveness.

Choice B reason: Milk contains calcium, which can bind to risedronate and prevent its absorption. Therefore, the client should not drink milk with or within 2 hours of taking risedronate.

Choice C reason: Withholding the medication until the client's breakfast tray is available is not appropriate, as it would delay the administration of risedronate and disrupt the dosing schedule. The client should take risedronate as soon as possible after waking up and before eating anything.

Choice D reason: Consulting with a pharmacist about scheduling the dose one hour after the client eats is not necessary, as risedronate should be taken at least 30 minutes before any food or beverage. Taking risedronate one hour after eating may not ensure adequate absorption of the drug.

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Correct Answer is A

Explanation

Choice A reason: This is the correct action to include in the client's plan of care, as sucralfate should be given on an empty stomach, at least one hour before meals and at bedtime. Sucralfate is a mucosal protectant that forms a protective barrier over the ulcer and prevents further damage from acid and pepsin. It requires an acidic environment to work, so it should not be taken with food or antacids.

Choice B reason: This is not a relevant action to include in the client's plan of care, as sucralfate does not cause or increase the risk of secondary Candida infection. Candida infection is a fungal infection that can affect the mouth, throat, esophagus, or vagina. It is more common in clients who use antibiotics, corticosteroids, or immunosuppressants, but not sucralfate.

Choice C reason: This is not an accurate action to include in the client's plan of care, as sucralfate should be administered four times a day, not once a day. Sucralfate has a short duration of action, so it needs to be taken frequently to maintain its protective effect on the ulcer.

Choice D reason: This is not a necessary action to include in the client's plan of care, as sucralfate does not cause or affect electrolyte imbalance. Electrolyte imbalance is an abnormality in the levels of sodium, potassium, calcium, magnesium, or other minerals in the blood. It can be caused by dehydration, vomiting, diarrhea, kidney disease, or other conditions, but not sucralfate.

A. Recent use of other antidepressants. B. Weight change in the last month. C. Family history of mental illness. D. Liver function laboratory results.

Correct Answer is D

Explanation

Choice A reason: Recent use of other antidepressants is important to know, as duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can interact with other antidepressants, especially monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). However, this information is not as important as liver function laboratory results, as duloxetine can cause hepatotoxicity in some clients.

Choice B reason: Weight change in the last month is relevant to monitor, as duloxetine can cause weight loss or gain in some clients. However, this information is not as important as liver function laboratory results, as duloxetine can cause liver damage in some clients.

Choice C reason: Family history of mental illness is useful to assess, as duloxetine may be more effective or less effective in clients with certain genetic factors. However, this information is not as important as liver function laboratory results, as duloxetine can cause liver failure in some clients.

Choice D reason: Liver function laboratory results are most important to obtain, as duloxetine is metabolized by the liver and can cause hepatotoxicity in some clients. The nurse should monitor the client's liver enzymes and bilirubin levels before and during treatment with duloxetine and report any signs of liver impairment, such as jaundice, dark urine, abdominal pain, or fatigue.

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