A client has a new prescription for Sucralfate. Which of the following instructions should the nurse include?

Correct Answer: A

Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) in the treatment of anxiety is typically 5-10 mcg/ml. This range is considered effective in managing anxiety symptoms while minimizing the risk of side effects associated with higher levels of the medication. Lower serum levels may be ineffective in treating anxiety, while higher levels increase the risk of adverse effects. Therefore, maintaining the serum concentration within the range of 5-10 mcg/ml is optimal for therapeutic benefits with minimal risks.

Correct Answer: A

Rationale: The nurse should include the instruction to avoid drinking large amounts of green tea when providing dietary teaching for a patient receiving warfarin (Coumadin) therapy because green tea contains vitamin K, which can interfere with the anticoagulant effects of warfarin. Maintaining consistent intake of vitamin K is important to ensure the effectiveness of warfarin therapy. Therefore, it is recommended for patients on warfarin to consume a consistent amount of vitamin K-containing foods and avoid sudden, significant changes in their intake.

Correct Answer: D

Rationale: The most common undesirable effect of thrombolytic therapy is bleeding, both internal and superficial. Thrombolytic agents work by dissolving blood clots, which can lead to an increased risk of bleeding. Patients receiving thrombolytic therapy should be closely monitored for signs of bleeding, such as easy bruising, petechiae, hematomas, or gastrointestinal bleeding. It is essential for healthcare providers to assess and manage the risk of bleeding while administering thrombolytic therapy to minimize potential complications. Dysrhythmias, nausea and vomiting, and anaphylactic reactions are less common adverse effects of thrombolytic therapy compared to bleeding.

Correct Answer: D

Rationale: The correct statement is that the heparin provides anticoagulation until therapeutic levels of warfarin are reached. Heparin has an immediate onset of action and is used initially to rapidly provide anticoagulation. Warfarin, on the other hand, has a delayed onset of action and requires several days to reach therapeutic levels in the bloodstream. Therefore, heparin is often overlapped with warfarin until the latter reaches its full anticoagulant effect. This overlapping strategy helps prevent a gap in anticoagulation and reduces the risk of blood clots. So, the statement that the heparin provides anticoagulation until therapeutic levels of warfarin are reached is the most correct in this case.