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. Continue with normal dose schedule after missing a dose:
If a dose of sucralfate is missed, continuing with the normal dosing schedule without additional instructions is not appropriate. Sucralfate is best taken on an empty stomach to ensure optimal effectiveness, so missing a dose may require specific instructions to address this.
B. Administer an additional dose if a dose is missed:
Taking an additional dose of sucralfate if one is missed is not recommended. This could lead to an overdose or increased side effects. The proper approach is to follow specific instructions for missed doses provided by the healthcare provider or the medication guidelines.
C. Take on an empty stomach at least 1 hour before meals:
Sucralfate should be taken on an empty stomach, typically at least 1 hour before meals. This allows the medication to adhere to the ulcer site effectively and protect it from stomach acid. This timing maximizes its therapeutic benefit in treating peptic ulcers.
D. Schedule doses with each meal and at bedtime:
While sucralfate is often taken multiple times a day, scheduling doses specifically with meals and at bedtime may not be ideal. The medication should be taken on an empty stomach, and scheduling around meals could interfere with its efficacy. Following the specific instruction of taking it at least 1 hour before meals ensures better adherence to its treatment protocol.

A. Osteoarthritis: Osteoarthritis is a common condition for which diclofenac is often prescribed. While it is important to monitor the effectiveness of the medication in treating osteoarthritis symptoms, the presence of this condition itself does not pose the greatest concern for the potential side effects or interactions of diclofenac.
B. Chronic alcoholism: Chronic alcoholism is of significant concern when a client is prescribed diclofenac. NSAIDs, including diclofenac, can irritate the gastrointestinal tract and increase the risk of gastrointestinal bleeding or ulcers, a risk that is heightened in individuals with a history of chronic alcoholism. This history makes monitoring for gastrointestinal side effects crucial, as chronic alcohol use can exacerbate these risks.
C. Type 2 diabetes mellitus: While diabetes mellitus can influence overall health and complicate the management of chronic conditions, it is not the most pressing concern related to the use of diclofenac. Diabetes management primarily involves monitoring blood glucose levels and managing diabetes-related complications, rather than the direct side effects of NSAIDs.
D. Migraine headaches: Migraine headaches are not directly related to the side effects or risks associated with diclofenac use. Although NSAIDs can be used to treat migraines, the presence of migraine headaches does not pose as significant a concern regarding the medication’s potential adverse effects as does a history of chronic alcoholism.