The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Allow the client to take the medication up to 1 hour after breakfast.

Instruct the client to take it when the meal tray is delivered.

Document the client's refusal of the medication at this time.

Explain the need to take the medication at least 1 hour before meals.

Answer and Explanation

The Correct Answer is D

A) Allow the client to take the medication up to 1 hour after breakfast:
Administering sucralfate up to 1 hour after breakfast may not provide optimal effectiveness as it should ideally be taken on an empty stomach to form a protective barrier over irritated areas in the stomach and intestines before food intake. Taking it after breakfast might not allow sufficient time for the medication to coat these areas adequately.

B) Instruct the client to take it when the meal tray is delivered:
Taking sucralfate with meals or when the meal tray is delivered is not recommended as food can interfere with its effectiveness. It is best taken on an empty stomach to allow it to coat the stomach lining without interference from food, ensuring maximum therapeutic benefit.

C) Document the client's refusal of the medication at this time:
Documenting a refusal should only be done if the client declines after receiving appropriate education and understanding. Simply refusing the client's request without providing education on the proper timing for taking sucralfate would not be appropriate.

D) Explain the need to take the medication at least 1 hour before meals:
This is the correct response. Educating the client about the importance of taking sucralfate at least 1 hour before meals ensures optimal effectiveness. This timing allows the medication to form a protective barrier over irritated areas in the stomach and intestines before food intake, maximizing its therapeutic benefit.

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Correct Answer is C

Explanation

A) Irrigation and topical antibiotic application to wound area: While wound care is important in managing infections, obtaining cultures before initiating antibiotic therapy takes precedence to ensure appropriate treatment. Topical antibiotics may not adequately address systemic infections caused by gram-negative bacteria.
B) Monitor for signs of sodium and fluid retention: This intervention is important when administering certain antibiotics, such as those in the aminoglycoside class, but it is not the most immediate priority. Monitoring for signs of sodium and fluid retention is typically indicated after antibiotic therapy has commenced and involves assessing the client's clinical status and laboratory values for signs of electrolyte imbalance or fluid overload.
C) Wound and blood specimens for culture and sensitivity: This action is essential before initiating antibiotic therapy because it allows for the identification of the specific organism causing the infection and its susceptibility to antibiotics. This information guides the selection of the most appropriate antibiotic for targeted therapy, improving treatment efficacy and reducing the risk of antibiotic resistance.
D) Complete blood count and serum electrolytes: While monitoring laboratory values is important in the overall management of the client, obtaining cultures for culture and sensitivity testing is the priority before initiating antibiotic therapy. This step helps ensure that the chosen antibiotic is effective against the specific pathogen causing the infection.

A. Stop the oral contraceptive immediately. B. Use an additional form of contraception. C. Take the medications at least 12 hours apart. D. Avoid prolonged exposure to direct sunlight.

Correct Answer is B

Explanation

A) Stop the oral contraceptive immediately:
This instruction is incorrect and potentially dangerous. Abruptly stopping oral contraceptives can lead to unintended pregnancy and disrupt the client's menstrual cycle. It's essential for the client to continue taking their oral contraceptive unless instructed otherwise by their healthcare provider.

B) Use an additional form of contraception:
This is the correct action. Erythromycin is an antibiotic that can reduce the effectiveness of oral contraceptives by altering the gut flora and potentially interfering with their absorption. Therefore, it is recommended to use an additional form of contraception, such as condoms, while taking erythromycin to prevent unintended pregnancy.

C) Take the medications at least 12 hours apart:
While it's generally a good practice to space medications apart to avoid interactions, specific instructions regarding the timing of erythromycin and oral contraceptive administration should be obtained from the healthcare provider. Simply spacing the medications apart may not be sufficient to prevent contraceptive failure.

D) Avoid prolonged exposure to direct sunlight:
This instruction is unrelated to the interaction between erythromycin and oral contraceptives. Erythromycin can increase sensitivity to sunlight (photosensitivity), but this does not affect the effectiveness of oral contraceptives. Therefore, while it's important to advise clients to protect themselves from sun exposure while taking erythromycin, it's not directly related to contraceptive use.

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The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Correct Answer is C

Explanation

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is B

Explanation

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A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?