A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take?

Choice A reason: Decreasing pain and burning during urination is not the purpose of probenecid, which is a drug that lowers the level of uric acid in the blood. Probenecid is used to treat gout, a condition that causes painful inflammation of the joints due to the accumulation of uric acid crystals. Probenecid does not have any effect on the urinary tract or its symptoms.

Choice B reason: Increasing the strength of the urine stream is not the purpose of probenecid, which is a drug that increases the amount of uric acid in the urine. Probenecid works by blocking the reabsorption of uric acid by the kidneys, thus increasing its excretion. Probenecid does not have any effect on the bladder or its function.

Choice C reason: Preventing the formation of kidney stones is not the purpose of probenecid, which is a drug that can actually increase the risk of kidney stones. Probenecid increases the concentration of uric acid in the urine, which can lead to the formation of uric acid stones. The nurse should instruct the client to drink plenty of fluids and avoid foods high in purines, such as organ meats, seafood, and alcohol, to prevent kidney stones.

Choice D reason: Promoting excretion of uric acid in the urine is the purpose of probenecid, which is a drug that reduces the level of uric acid in the blood. Probenecid helps prevent gout attacks by preventing the buildup of uric acid crystals in the joints. The nurse should monitor the client's serum uric acid level, renal function, and urine output, and advise the client to take the medication with food to avoid stomach upset.

Choice A reason: This is not a correct action for the nurse to include in this client's plan of care. Administering sucralfate once a day, preferably at bedtime, is not the recommended dosage or timing for this medication. Sucralfate is a mucosal protectant that forms a protective barrier over the ulcer and prevents further damage from acid and pepsin. It should be taken four times a day, one hour before meals and at bedtime, to ensure optimal coverage and healing of the ulcer.

Choice B reason: This is the correct action for the nurse to include in this client's plan of care. Giving sucralfate on an empty stomach is essential for the effectiveness of this medication. Sucralfate needs an acidic environment to activate and form a complex with the ulcer site. If the client takes sucralfate with food or beverages, the pH of the stomach may increase and reduce the ability of sucralfate to bind to the ulcer. The client should take sucralfate one hour before meals and at bedtime, and avoid antacids within 30 minutes of taking sucralfate.

Choice C reason: This is not a correct action for the nurse to include in this client's plan of care. Monitoring for electrolyte imbalance is not a specific or relevant intervention for this medication. Sucralfate does not affect the electrolyte levels in the blood, as it is not absorbed systemically and does not alter the renal function. The nurse should monitor the electrolyte levels for other reasons, such as dehydration, vomiting, or diuretic use, but not because of sucralfate therapy.

Choice D reason: This is not a correct action for the nurse to include in this client's plan of care. Assessing for secondary Candida infection is not a common or necessary intervention for this medication. Sucralfate does not increase the risk of fungal infections, as it does not suppress the immune system or alter the normal flora of the GI tract. The nurse should assess for signs of infection, such as fever, leukocytosis, or purulent drainage, for other reasons, such as perforation, abscess, or sepsis, but not because of sucralfate therapy.