A client with Peptic Ulcer Disease who is taking Sucralfate PO has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

Correct Answer: C

Rationale: In this scenario, the correct instruction that the nurse should provide is option C: Allow a 2-hour interval between these medications. Explanation: Phenytoin is a medication that can interact with sucralfate when taken simultaneously. Sucralfate can bind to phenytoin in the gastrointestinal tract, reducing the absorption and effectiveness of phenytoin. By spacing out the administration of these medications by 2 hours, the interaction can be minimized, allowing each drug to be absorbed and utilized effectively. Why the other options are wrong: A) Taking an antacid with sucralfate can alter its pH-dependent mechanism of action, reducing its efficacy in treating Peptic Ulcer Disease. B) Taking sucralfate with milk can also affect its absorption and effectiveness due to changes in pH and potential interactions with components of the milk. D) Chewing sucralfate before swallowing is not recommended as it can alter its intended release and mechanism of action in the gastrointestinal tract. Educational context: Understanding drug interactions and appropriate medication administration is crucial in pharmacology. Nurses play a vital role in educating patients to ensure safe and effective medication use. This scenario highlights the importance of knowing how medications can interact and the significance of proper timing to optimize therapeutic outcomes.

Correct Answer: A

Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early.

Correct Answer: C

Rationale: The correct answer is C. Erythromycin should be taken on an empty stomach with a full glass of water to increase absorption. Taking it with a full glass of milk (Choice A) is incorrect. Avoiding direct sunlight (Choice B) is not related to erythromycin use. Taking an antacid before the medication (Choice D) can interfere with its absorption.

Correct Answer: B

Rationale: The correct answer is B) You should stop taking this medication if you develop a rash. This teaching point is crucial because ceftriaxone is a cephalosporin antibiotic known to cause severe hypersensitivity reactions, including rashes. It is important for the client to be aware that the development of a rash could indicate a serious allergic reaction that requires immediate medical attention. By instructing the client to discontinue the medication and seek medical help if a rash occurs, the nurse is promoting patient safety and preventing potentially life-threatening complications. Options A, C, and D are incorrect: A) You may develop a cough while taking this medication. While cough can be a side effect of some medications, it is not a common or significant side effect of ceftriaxone. This information is not a priority teaching point for this specific medication. C) This medication can be given orally. Ceftriaxone is not available for oral administration; it is typically administered intravenously or intramuscularly. Providing this information could lead to medication errors or confusion for the client. D) This medication may cause your urine to turn yellow. While ceftriaxone can cause a harmless side effect of yellow discoloration of urine due to the excretion of the drug, this is a minor concern compared to the potential serious allergic reactions associated with this medication. It is not a critical teaching point compared to the need to monitor for and respond to a rash. In an educational context, understanding the side effects, administration routes, and monitoring parameters of medications are crucial for nurses to ensure safe and effective patient care. Teaching clients about medication-specific information empowers them to take an active role in their treatment and promotes adherence to prescribed regimens.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Diphenhydramine. The client's presentation of facial spasms after receiving Prochlorperazine indicates a possible extrapyramidal side effect, specifically acute dystonia. Diphenhydramine, an antihistamine with anticholinergic properties, is commonly used to manage these types of extrapyramidal symptoms. Option A) Fomepizole is used in the treatment of ethylene glycol or methanol poisoning and is not relevant to the client's current symptoms. Option B) Naloxone is a medication used to reverse opioid overdose, which is unrelated to the client's facial spasms. Option C) Phytonadione is vitamin K, used to reverse the effects of excessive anticoagulation, which is not indicated in this case. Educationally, understanding the side effects of medications and appropriate interventions is crucial for safe and effective nursing practice. Recognizing and managing adverse drug reactions promptly can prevent complications and improve patient outcomes. This question highlights the importance of pharmacological knowledge and critical thinking skills in nursing care.