The nurse is caring for a client receiving a prescription for sucralfate to treat a peptic ulcer. Which instruction should the nurse provide during discharge education?

A. Explore what the client means by the drug "is not working": This is the most appropriate initial intervention. It is essential to understand the client's specific concerns and symptoms they are experiencing to assess whether the medication is meeting its intended effects or if there may be issues with dosing, timing, or expectations. This step helps clarify the client's experience and guides further assessment.
B. Determine if the client is taking the medication before meals: While the timing of carbidopa-levodopa intake relative to meals can affect its absorption, understanding the client's specific concerns about the medication's effectiveness should come first. If the medication is not working as expected, checking administration timing is one aspect to explore after clarifying the client's concerns.
C. Evaluate the client for signs of dyskinesia: Dyskinesia, which refers to involuntary movements, can be a side effect of long-term use of carbidopa-levodopa. However, before evaluating for specific side effects, it is crucial to first understand the client's perception of the medication's effectiveness.
D. Ask if the client's morning voids are dark colored: This is less relevant to the immediate concern of the medication's effectiveness. While urine color can sometimes be affected by medications or their side effects, addressing the client's specific concern about the medication's effectiveness is more pertinent.

A. Check blood glucose levels every six hours: Monitoring blood glucose levels is crucial for managing diabetes, but checking them every six hours may not be frequent enough for clients on insulin lispro. This rapid-acting insulin requires closer monitoring, particularly around mealtimes, to effectively manage blood glucose levels and adjust dosing as needed.
B. Assess for hypoglycemia between meals: Assessing for hypoglycemia is important, but it is not the most critical intervention specifically related to the administration of insulin lispro. This insulin acts quickly and is closely tied to meal timing, so the primary focus should be on ensuring proper meal timing to prevent hypoglycemia.
C. Provide meals at the same time this insulin is given: Insulin lispro is a rapid-acting insulin that begins to work within 15 minutes and peaks around 1-2 hours after administration. It is crucial to provide meals at the same time or shortly after administering insulin lispro to match the timing of the insulin’s peak effect and prevent hypoglycemia. This synchronization helps ensure that the glucose from the meal is available to counterbalance the insulin's action.
D. Keep an oral liquid or glucose source available: While it is important to have a source of glucose available in case of hypoglycemia, the most critical intervention for managing insulin lispro is ensuring that the client receives their meals in sync with the insulin administration. Having a glucose source is a good safety measure, but providing meals at the appropriate time is more directly related to the effective use of rapid-acting insulin.