A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?

Correct Answer: A

Rationale: In pharmacology, it is crucial to provide accurate instructions to clients starting new medications to ensure optimal outcomes. In the case of Metformin, it is important to take the medication with food to reduce gastrointestinal side effects such as nausea and diarrhea. Option A, "Take this medication with your first bite of food," is correct because it helps minimize these side effects and ensures better absorption of the drug. Option B, "Take this medication on an empty stomach," is incorrect because taking Metformin without food can lead to increased gastrointestinal side effects and may affect drug absorption. Option C, "Take this medication before bedtime," is also incorrect as there is no specific requirement to take Metformin at bedtime. Option D, "Take this medication every other day," is incorrect as Metformin is typically prescribed for daily use to maintain stable blood levels. Educationally, understanding the rationale behind the timing of medication administration is essential for safe and effective practice. Providing clear instructions to clients promotes medication adherence and reduces the risk of adverse effects. It is important for healthcare providers to stay informed about drug administration guidelines to ensure the best possible outcomes for their clients.

Correct Answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.

Correct Answer: B

Rationale: Diltiazem is a calcium channel blocker that can cause bradycardia as an adverse effect due to its negative chronotropic properties, slowing down the heart rate. Therefore, the nurse should monitor the client for signs of bradycardia by regularly assessing the heart rate to prevent potential complications.

Correct Answer: B

Rationale: When a client is prescribed Digoxin, monitoring potassium levels is crucial as hypokalemia can increase the risk of Digoxin toxicity. Low potassium levels can potentiate the effects of Digoxin on the heart, leading to toxicity. Therefore, regular monitoring of potassium levels helps in preventing adverse effects and ensuring the safe use of Digoxin.

Correct Answer: B

Rationale: Nifedipine is a calcium channel blocker commonly used to treat hypertension and angina. The correct answer is B) Edema. Nifedipine can cause peripheral edema due to its vasodilatory effects, leading to fluid accumulation in the extremities. This adverse effect is important to monitor as it can impact the client's comfort and compliance with the medication. A) Hypertension is incorrect because Nifedipine is actually used to treat hypertension by causing vasodilation and reducing blood pressure. C) Hyperglycemia is not a common adverse effect of Nifedipine. In fact, calcium channel blockers are typically considered safe for patients with diabetes. D) Bradycardia is unlikely with Nifedipine as it does not have a direct effect on heart rate. In fact, it may cause reflex tachycardia as a compensatory mechanism for the drop in blood pressure. Educationally, understanding the common adverse effects of medications is crucial for safe medication administration and patient monitoring. Nurses need to be familiar with potential side effects to provide comprehensive care, educate patients, and intervene promptly if adverse reactions occur.