A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

A) Advising the client to limit foods containing vitamin D is not appropriate. Phenytoin can lead to decreased vitamin D levels, making it important to maintain adequate vitamin D intake to support bone health. Therefore, there is no need to restrict these foods.

B) Taking phenytoin with food can help reduce gastrointestinal side effects and improve absorption, making this instruction crucial for the client’s adherence to the medication regimen. It is important for older adults, who may be more sensitive to medications, to have guidance on how to take their medications effectively.

C) Planning to take phenytoin with antacids is not advisable, as antacids can interfere with the absorption of phenytoin. The nurse should instruct the client to space these medications apart to avoid reduced effectiveness of phenytoin.

D) Limiting foods that contain folic acid is unnecessary and not typically advised. In fact, folic acid is important for overall health, and some patients on phenytoin may need additional folic acid supplementation, especially if they have a deficiency. Therefore, this instruction may lead to unintended nutritional deficiencies.

A) Schedule nursing staff training for infection control procedures: While staff training is important for reducing infection rates, it is a secondary step. First, understanding the underlying factors contributing to the increase in catheter infections is crucial.

B) Identify possible precipitating factors related to the infections: This action should be the priority. By identifying the specific causes or trends associated with the increase in infections, the charge nurse can target interventions more effectively and implement changes based on evidence.

C) Meet with providers to discuss measures to decrease the infections: Engaging providers is important, but it should occur after identifying the root causes. Once the contributing factors are understood, a more focused discussion can take place.

D) Revise the current policy for catheter care: While policy revision may be necessary, it is essential to first assess the current situation to understand why the infections are occurring. Without identifying the factors first, changes made may not address the actual issues at hand.