A nurse is teaching a client about the uses of chamomile. Which of the following information should the nurse include in the teaching?

Choice A reason:

The statement “Rinse mouth 2 times per day with an alcohol-based mouthwash” is incorrect. Methotrexate can cause mouth sores and irritation, and using an alcohol-based mouthwash can exacerbate these symptoms. Instead, patients are often advised to use a non-alcoholic mouthwash or a saline rinse to help prevent and soothe mouth sores.

Choice B reason:

The statement “Take the medication with an NSAID” is incorrect. Methotrexate should not be taken with nonsteroidal anti-inflammatory drugs (NSAIDs) without medical supervision because this combination can increase the risk of severe side effects, including bone marrow suppression and gastrointestinal toxicity. Patients should always consult their healthcare provider before combining these medications.

Choice C reason:

The statement “Take an antiemetic 1 hour following administration” is not standard advice for methotrexate. While methotrexate can cause nausea, antiemetics are typically taken before or at the same time as the methotrexate dose to prevent nausea, not after. Patients should follow their healthcare provider’s instructions regarding the timing of antiemetics.

Choice D reason:

The statement “Drink 2 to 3 liters of water per day” is correct. Methotrexate can cause kidney damage, and staying well-hydrated helps to prevent this by promoting the excretion of the drug and reducing its concentration in the kidneys. Drinking plenty of fluids is an important part of managing methotrexate therapy safely.

Choice A reason:

Explaining the discharge instructions to the client and parents is important for ensuring they understand how to care for the cast and recognize signs of complications. However, this is not the immediate priority. The primary concern should be assessing the client’s current condition to ensure there are no immediate risks, such as compromised circulation or nerve damage.

Choice B reason:

Performing a neurovascular assessment is the priority action. This assessment involves checking for circulation, movement, and sensation in the affected limb. It is crucial to identify any signs of neurovascular compromise, such as decreased blood flow or nerve damage, which can occur with a new cast. Early detection of these issues can prevent serious complications.

Choice C reason:

Providing reassurance to the client and parents is important for their emotional well-being and can help reduce anxiety. However, it is not the immediate priority. Ensuring the physical health and safety of the client through a neurovascular assessment takes precedence.

Choice D reason:

Applying an ice pack to the casted leg can help reduce swelling and pain, but it is not the immediate priority. The first step should be to assess the neurovascular status to ensure there are no urgent issues that need to be addressed.