A nurse is planning care for an infant who has congenital talipes equinovarus. Which of the following referrals should the nurse expect the provider to make?

A. "Monitor your child for excessive sleepiness."

Methylphenidate is a central nervous system stimulant used to treat attention deficit hyperactivity disorder (ADHD). It typically causes insomnia or decreased need for sleep rather than excessive sleepiness. This option is incorrect, as it does not align with the expected side effects of the medication.

B. "Administer the medication with a caffeinated beverage."

Caffeine is also a stimulant, and combining it with methylphenidate could increase the risk of side effects such as increased heart rate, anxiety, or jitteriness. This instruction is incorrect and unsafe.

C. "Administer the second dose of the medication at lunch time."

Methylphenidate is usually given in divided doses, with the second dose often administered at lunchtime. This timing helps maintain therapeutic levels during the school day while minimizing the risk of insomnia. This option is correct and appropriate for managing the medication.

D. "Monitor your child for weight gain."

A common side effect of methylphenidate is appetite suppression, which can lead to weight loss, not weight gain. This option is incorrect, as the nurse should instruct the parent to monitor for weight loss instead.

A. "Expect the medication to cause constipation for the first few days of therapy.": This statement is incorrect. Metformin commonly causes gastrointestinal side effects such as diarrhea, abdominal discomfort, and nausea, especially when therapy is initiated. Constipation is not typically associated with metformin use.

B. "Take the medication at the same time each day.": This is a correct instruction. It is important for the adolescent to take metformin at the same time each day to maintain consistent blood levels of the medication and optimize its effectiveness.

C. "This medication is used for short-term therapy until your symptoms improve.": This statement is incorrect. Metformin is typically used for long-term management of type 2 diabetes mellitus to help control blood sugar levels. It is not intended for short-term therapy.

D. "Take this medication 1 hour before meals.": This statement is incorrect. While metformin can be taken with meals to reduce gastrointestinal side effects, it is not necessary to take it specifically 1 hour before meals. It can be taken with meals or shortly after meals.