Which intervention is most important for the nurse to implement for a client who is receiving insulin lispro?

Choice A reason: This is the correct action for the nurse to take. Risedronate is a bisphosphonate that is used to treat osteoporosis by inhibiting bone resorption. It should be taken with a full glass of water at least 30 minutes before the first food or drink of the day, as food and beverages can reduce its absorption and effectiveness. Milk and other dairy products are especially problematic, as they contain calcium, which can bind to risedronate and prevent it from reaching the bone.

Choice B reason: This is not a correct action for the nurse to take. Assigning a UAP to bring the client a glass of low fat milk is not appropriate, as it contradicts the instruction to take risedronate with water only. Low fat milk still contains calcium, which can interfere with risedronate absorption. The nurse should educate the client and the UAP about the proper administration of risedronate and the importance of avoiding food and beverages for at least 30 minutes after taking the medication.

Choice C reason: This is not a correct action for the nurse to take. Consulting with a pharmacist about scheduling the dose one hour after the client eats is not necessary, as risedronate should be taken before the first food or drink of the day, not after. Taking risedronate one hour after eating may not ensure adequate absorption and efficacy, as food and beverages can remain in the stomach for longer periods of time. The nurse should follow the prescribed schedule and the manufacturer's guidelines for risedronate administration.

Choice D reason: This is not a correct action for the nurse to take. Withholding the medication until the client's breakfast tray is available on the unit is not advisable, as it may delay the treatment of osteoporosis and increase the risk of fractures. Risedronate should be taken as soon as possible after waking up, before the first food or drink of the day, to maximize its absorption and effectiveness. The nurse should not postpone the medication administration without consulting the healthcare provider.

Choice A reason: This is not the first action for the nurse to implement. Determining when the last dose was administered is important to prevent overdose and adverse effects of pain medication, but it is not the most immediate intervention. The nurse should first assess the client's pain level and intensity using a pain scale, such as a numeric or a visual analog scale, to determine the appropriate dose and frequency of pain medication.

Choice B reason: This is not the first action for the nurse to implement. Encouraging the client to use diversional thoughts to manage pain is a nonpharmacological strategy that may help reduce the perception of pain and enhance coping, but it is not the most effective intervention. The nurse should first assess the client's pain level and intensity using a pain scale, and then provide pharmacological and nonpharmacological interventions as needed.

Choice C reason: This is not the first action for the nurse to implement. Reviewing the history for a past use of recreational drugs is relevant to identify the risk of addiction, tolerance, or withdrawal from pain medication, but it is not the most urgent intervention. The nurse should first assess the client's pain level and intensity using a pain scale, and then consider the client's history and preferences when selecting the type and dose of pain medication.

Choice D reason: This is the first action for the nurse to implement. Asking the client to rate the current level of pain using a pain scale is the most appropriate and accurate way to assess the client's pain and its impact on the client's recovery and quality of life. The nurse should use a pain scale that is suitable for the client's age, cognitive ability, and language, and ask the client to rate the pain at rest and with movement. The nurse should also ask the client about the location, quality, duration, and aggravating or relieving factors of the pain. The nurse should use the pain assessment as the basis for planning and implementing pharmacological and nonpharmacological interventions for pain management.