A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease (GERD) about minimizing the effects of reflux during sleep. Which of the following client statements indicates an understanding of the teaching?

When reinforcing teaching with a client who has a duodenal ulcer and a new prescription for sucralfate, the nurse should include the following instructions:

"Take the medication on an empty stomach.": Sucralfate is most effective when taken on an empty stomach, usually 1 hour before meals and at bedtime. Taking it with food or other medications may reduce its effectiveness.

"Remain upright for 30 minutes after taking this medication.": To enhance the efficacy of sucralfate, it is important to remain upright for at least 30 minutes after taking the medication. This helps to prevent the medication from being washed away by stomach acid and allows it to form a protective coating over the ulcer.

The following statements are incorrect or not applicable:

"Stop taking this medication if you develop constipation.": Constipation is a common side effect of sucralfate. However, abruptly stopping the medication is not necessary if constipation occurs. The nurse should instruct the client to increase fluid intake, consume a high-fiber diet, and discuss any concerns with the healthcare provider. If constipation becomes severe or persists, the healthcare provider can provide further guidance on managing this side effect.

"Take an antacid at the same time you take this medication.": Sucralfate can interact with antacids and other medications, reducing its effectiveness. It is recommended to take sucralfate at least 2 hours before or after taking antacids or other medications to avoid interference with its absorption.

Bisacodyl is a stimulant laxative commonly used to treat constipation. However, it is important to educate the client about the potential risks associated with chronic laxative use. The statement regarding electrolyte imbalance is important because excessive or prolonged use of laxatives can lead to electrolyte disturbances, such as low potassium levels (hypokalemia), which can have adverse effects on various body functions.

"Daily bowel movements are necessary for good intestinal health": While regular bowel movements are generally desirable, stating that daily bowel movements are necessary for good intestinal health is an overgeneralization. Bowel movement frequency can vary among individuals, and it is important to consider other factors such as diet, hydration, and overall health.

"Chronic use of laxatives can lead to a tear in the rectal mucosa": While chronic use of laxatives can lead to complications such as dependence and potential damage to the digestive system, specifically mentioning a tear in the rectal mucosa (rectal mucosal injury) is not the most commonly associated concern.

"Decrease your intake of high-fiber foods": It is generally recommended to increase fiber intake for individuals with constipation. Decreasing high-fiber foods would counteract the benefits of dietary fiber in promoting regular bowel movements and alleviating constipation.