The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?

Choice A reason: A basic metabolic panel is a blood test that measures the levels of electrolytes, glucose, blood urea nitrogen, creatinine, and calcium in the body. It can be used to assess the fluid balance, kidney function, and acid-base balance of the client. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice B reason: A thyroid function test is a blood test that measures the levels of thyroid hormones and thyroid-stimulating hormone in the body. It can be used to diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism, which can affect the metabolism, energy, and mood of the client. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice C reason: A renal function panel is a blood test that measures the levels of creatinine, blood urea nitrogen, and uric acid in the body. It can be used to assess the kidney function and the excretion of waste products from the body. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice D reason: A liver function test is a blood test that measures the levels of enzymes, proteins, and bilirubin in the body. It can be used to assess the liver function and the production and metabolism of bile. Albendazole is a medication that can cause liver toxicity and hepatitis, which can lead to symptoms such as fatigue, nausea, dark urine, and jaundice. The nurse should review the liver function test to monitor the client's liver status and adjust the medication dose accordingly.

Choice A reason: This is not a correct action for the nurse to include in this client's plan of care. Administering sucralfate once a day, preferably at bedtime, is not the recommended dosage or timing for this medication. Sucralfate is a mucosal protectant that forms a protective barrier over the ulcer and prevents further damage from acid and pepsin. It should be taken four times a day, one hour before meals and at bedtime, to ensure optimal coverage and healing of the ulcer.

Choice B reason: This is the correct action for the nurse to include in this client's plan of care. Giving sucralfate on an empty stomach is essential for the effectiveness of this medication. Sucralfate needs an acidic environment to activate and form a complex with the ulcer site. If the client takes sucralfate with food or beverages, the pH of the stomach may increase and reduce the ability of sucralfate to bind to the ulcer. The client should take sucralfate one hour before meals and at bedtime, and avoid antacids within 30 minutes of taking sucralfate.

Choice C reason: This is not a correct action for the nurse to include in this client's plan of care. Monitoring for electrolyte imbalance is not a specific or relevant intervention for this medication. Sucralfate does not affect the electrolyte levels in the blood, as it is not absorbed systemically and does not alter the renal function. The nurse should monitor the electrolyte levels for other reasons, such as dehydration, vomiting, or diuretic use, but not because of sucralfate therapy.

Choice D reason: This is not a correct action for the nurse to include in this client's plan of care. Assessing for secondary Candida infection is not a common or necessary intervention for this medication. Sucralfate does not increase the risk of fungal infections, as it does not suppress the immune system or alter the normal flora of the GI tract. The nurse should assess for signs of infection, such as fever, leukocytosis, or purulent drainage, for other reasons, such as perforation, abscess, or sepsis, but not because of sucralfate therapy.