A client asks a nurse how long a heat application should be left in place. Which response should the nurse make?

This is because non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are used to treat rheumatoid arthritis by reducing pain, inflammation, and swelling.

However, NSAIDs do not slow down the disease progression or prevent joint

damage. Therefore, they are often used along with other types of medications, such as methotrexate or biologics, that can modify the disease course. NSAIDs may take up to two weeks to reach their full anti-inflammatory effect.

Choice A is wrong because using aspirin to relieve other types of pain can increase the risk of bleeding and stomach ulcers when taken with NSAIDs.

Choice C is wrong because taking the medication on an empty stomach can increase the risk of stomach irritation and ulcers.

Choice D is wrong because taking the medication after exercising does not prevent the progression of disease or joint damage.

Take this medication at least 30 minutes before ingesting any food or medication.

This is because alendronate (Fosamax) is a bisphosphonate that works by inhibiting the breakdown and reabsorption of bone. However, it has a very low bioavailability, which means that only a small amount of the drug is absorbed into the bloodstream when taken orally. Therefore, taking it with food or other medications can interfere with its absorption and reduce its effectiveness.

The other choices are wrong because:

A. Chew the tablet well and report any difficulty swallowing. This is wrong because alendronate tablets should not be chewed or crushed, but swallowed whole with a full glass of plain water. Chewing or crushing the tablets can increase the risk of irritation or damage to the esophagus (the tube that connects the mouth to the stomach). Difficulty swallowing is a possible side effect of alendronate and should be reported to the doctor, but it is not an instruction for taking the medication.

B. Take the medication with six to eight ounces of milk. This is wrong because milk contains calcium, which can bind to alendronate and prevent its absorption. Alendronate should not be taken with any beverages other than plain water.

C. Lie down for 15 to 30 minutes after taking the medication. This is wrong because lying down after taking alendronate can increase the risk of esophageal irritation or

ulceration. Alendronate should be taken in the morning, at least 30 minutes before eating or drinking anything, and the person should remain upright (sitting or standing) for at least 30 minutes after taking it.

Normal ranges for bone density are expressed as T-scores, which compare a person’s bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis.