The nurse is to administer insulin to a diabetic client. The finger stick blood glucose is 128.

The client has 4 units of insulin lispro scheduled with meals in addition to the following adjustments scale. How many units of insulin will the nurse administer?

Choice A rationale
Sucralfate is a medication used to treat and prevent ulcers. It works by forming a protective barrier over the ulcer, allowing it to heal. Therefore, the statement “This medication will help prevent future ulcers” is correct.
Choice B rationale
Sucralfate should be taken on an empty stomach, not with food. This is because food can interfere with the medication’s ability to form a protective barrier over the ulcer.
Choice C rationale
Constipation is a common side effect of sucralfate. Therefore, the statement “This medication can cause constipation” is correct.
Choice D rationale
Coughing up blood can be a sign of a serious condition, such as a bleeding ulcer. If a patient taking sucralfate starts coughing up blood, they should definitely call their doctor.

Choice A rationale
A client with a hip fracture and is on bedrest for 4 weeks may indeed experience constipation due to decreased physical activity. However, this situation would not necessarily require the nurse to question the order for psyllium. Psyllium is a bulk-forming laxative that can help relieve constipation by increasing stool bulk and improving bowel regularity.
Choice B rationale
Morphine is an opioid medication that can cause constipation as a side effect. Therefore, a client who is experiencing severe pain and is prescribed morphine may benefit from a laxative like psyllium to help manage opioid-induced constipation. This situation would not necessarily require the nurse to question the order for psyllium.
Choice C rationale
A client who is post-operative and is on a clear liquid diet may experience constipation due to the low fiber content of the diet. However, this situation would not necessarily require the nurse to question the order for psyllium. Once the client progresses to a regular diet, psyllium can help add bulk to the stool and promote regular bowel movements.
Choice D rationale
This choice is correct. A client with a recent stroke who has difficulty swallowing may be at risk for aspiration, or the inhalation of food or liquid into the lungs, when taking psyllium. Psyllium is a bulk-forming laxative that absorbs water in the intestines to form a softer, bulkier stool. If a client with swallowing difficulties were to aspirate the psyllium, it could potentially expand in the lungs when it comes into contact with moisture, leading to serious complications. Therefore, the nurse should question the order for psyllium in this situation.