A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

A) Provide information on increasing medication dosage if ketoacidosis occurs: While it is important for clients with diabetes to understand the signs and symptoms of diabetic ketoacidosis (DKA) and how to respond, increasing insulin dosage on their own without healthcare provider guidance could be dangerous. Adjusting insulin dosage should always be done under the direction of a healthcare provider.

B) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin used for basal (background) insulin coverage in clients with diabetes. Teaching the client how to self-administer insulin injections is essential for effective management of diabetes, especially when using long-acting insulin formulations like insulin glargine. Proper injection technique, site rotation, and storage of insulin are important aspects of this teaching.

C) Demonstrate how to select dose based on before meal blood sugar readings: Insulin glargine is typically administered once daily at the same time each day and is not adjusted based on before meal blood sugar readings. Instead, it provides a steady level of insulin over 24 hours to help control blood sugar levels between meals and overnight.

D) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is not used for the treatment of severe hypoglycemia. Instead, it is a long-acting insulin used to maintain basal insulin levels in clients with diabetes. Severe hypoglycemia is treated with fast-acting glucose sources such as oral glucose tablets, gel, or glucagon injections, and the family should be educated on these treatments instead.

A) Notify the healthcare provider of the contraindication to tetracyclines: Tetracyclines, including doxycycline hyclate, are not contraindicated in clients taking birth control pills. While there may be interactions between these medications, they are not absolute contraindications.

B) Advise the client that the oral birth control will be less effective while taking doxycycline hyclate: Doxycycline hyclate, like other antibiotics, may reduce the effectiveness of oral contraceptives by altering the gut flora and interfering with the enterohepatic circulation of estrogen. Clients should be informed of this potential interaction and advised to use an additional form of contraception (such as condoms) while taking the antibiotic and for a period afterward.

C) Instruct the client to take the two medications at least two hours apart: While separating the administration of doxycycline hyclate and oral contraceptives by two hours may reduce the potential for interaction, it is not the standard recommendation. It is generally advised to use additional contraceptive methods during antibiotic therapy and for a period afterward, rather than relying solely on timing of medication administration.

D) Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate: Stopping oral contraceptives abruptly is not recommended and may lead to unintended pregnancy. Instead, clients should be advised to use additional contraceptive methods while taking doxycycline hyclate and for a period afterward to ensure continued protection against pregnancy.