A nurse is teaching a client who has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer: A

Rationale: In this scenario, option A, "I will need to get my blood drawn periodically while on this medication," is the correct answer. Etanercept is a biologic disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis. Regular monitoring of blood parameters, including complete blood count and liver function tests, is crucial to assess for potential adverse effects such as cytopenias and hepatotoxicity. This statement indicates the client understands the importance of monitoring while on this medication. Option B, "I should stop taking this medication if I develop a rash," is incorrect. While it is essential to report any adverse reactions to healthcare providers, a rash alone may not necessarily warrant discontinuation of Etanercept. It is crucial for the client to consult their healthcare provider before making any decisions regarding medication cessation. Option C, "I will need to limit my alcohol intake to no more than one drink per week," is also incorrect. While alcohol moderation is generally advisable, there is no specific restriction on alcohol intake associated with Etanercept use. The focus should be on adherence to the prescribed treatment regimen and regular follow-up with healthcare providers. Option D, "I should self-administer this medication subcutaneously into the muscle," is incorrect. Etanercept is typically administered subcutaneously into fatty tissue, not into the muscle. Proper injection technique, site rotation, and disposal of needles should be taught to the client to ensure safe and effective medication administration. In an educational context, it is crucial for nurses to provide clear and accurate information to clients about their medications to promote medication adherence and safety. Understanding the rationale behind various aspects of medication administration and monitoring empowers clients to take an active role in their healthcare management. Regular reinforcement of medication teaching and monitoring requirements can help clients manage their condition effectively and minimize potential risks.

Correct Answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This recommendation aims to reduce the risk of kidney stones, a potential side effect associated with allopurinol use. Adequate hydration helps prevent the formation of uric acid crystals in the kidneys, which can lead to kidney stones. Therefore, encouraging increased water intake is essential in the management of clients taking allopurinol.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic. The client should avoid salt substitutes because they often contain potassium, which could lead to hyperkalemia. Hyperkalemia, or high levels of potassium in the blood, is a potential side effect of spironolactone, and ingesting additional potassium from salt substitutes can exacerbate this risk.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Kava. Kava is known to potentially cause hepatotoxicity and liver enzyme elevation. Therefore, it is crucial for the nurse to report the client's use of Kava to the healthcare provider to assess for any adverse effects on liver function. Option A) Glucosamine is commonly used for joint health and is not typically associated with liver enzyme elevation to the extent that would warrant immediate reporting. Option B) Saw palmetto is primarily used for benign prostatic hyperplasia and has minimal impact on liver enzymes. Option D) St. John's wort is often used for depression but is more commonly associated with drug interactions rather than liver enzyme elevation. Educationally, this question highlights the importance of understanding the potential adverse effects of herbal supplements, especially on liver function. Nurses need to be vigilant in assessing clients' use of herbal products and be aware of the specific risks associated with each supplement to ensure client safety and well-being.

Correct Answer: B

Rationale: Isosorbide, an organic nitrate used for angina, is contraindicated with sildenafil due to the risk of fatal hypotension. Concurrent use of these medications can lead to severe hypotension. Patients are advised to avoid taking nitrate medications for 24 hours after using isosorbide to prevent this dangerous interaction.