A nurse is reviewing the medication record of a client who has hypertension. Which of the following medications should the nurse administer to lower the client's blood pressure?

A. Add the medications to the enteral feeding bag. Medications should not be mixed with enteral feeding formula as this can alter drug absorption, cause tube clogging, or result in medication interactions. Each medication should be administered separately to ensure proper effectiveness.

B. Check for gastric residual 15 min after administering the medications. Gastric residual volume (GRV) should be checked before medication administration to assess delayed gastric emptying. Checking it after administration is unnecessary and may disrupt medication absorption without clinical benefit.

C. Keep the client's head elevated 15° while administering the medications. The head of the bed should be elevated at least 30–45 degrees, not 15 degrees, to reduce aspiration risk and promote medication passage. Insufficient elevation increases the likelihood of regurgitation and aspiration pneumonia.

D. Flush the tube with 30 ml of water between each medication. Flushing with 30 mL of water between medications prevents tube clogging and ensures each drug is properly delivered. It also minimizes drug interactions by preventing medications from mixing within the tube.

A. Glucosamine. Glucosamine is a supplement used to support joint health, particularly in osteoarthritis. It does not have significant interactions with digoxin and is not known to affect cardiac function or digoxin metabolism, making it safe to use concurrently.

B. Garlic. Garlic has blood-thinning properties and may mildly lower blood pressure, but it does not directly interfere with digoxin metabolism. However, clients on anticoagulants or blood pressure medications should use garlic cautiously due to its potential to enhance their effects.

C. St. John's wort. St. John’s wort induces liver enzymes that can increase the metabolism of many medications, including digoxin. This can lead to decreased digoxin levels, reducing its effectiveness and increasing the risk of uncontrolled heart failure or atrial fibrillation. Clients taking digoxin should avoid St. John’s wort to maintain therapeutic drug levels.

D. Ginkgo biloba. Ginkgo biloba is primarily used to enhance cognitive function and circulation. While it has mild blood-thinning effects, it does not significantly impact digoxin metabolism. However, caution is advised in clients taking anticoagulants or antiplatelet medications to avoid an increased risk of bleeding.