A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Choice A reason: Suggesting the use of an antacid two hours after taking risedronate is not the best initial response. While antacids can help with heartburn, they can also interfere with the absorption of risedronate if taken too close to the medication. It is more important to first understand how the client is taking the medication to ensure proper administration.

Choice B reason: Reminding the client to take the medication with plenty of water is good advice, as risedronate should be taken with a full glass of water to prevent esophageal irritation. However, this response does not address the immediate concern of increasing heartburn. Understanding the client’s current administration method is crucial.

Choice C reason: Asking the client to describe how she takes the medication is the most appropriate response. This allows the nurse to identify any potential issues with the administration technique, such as not taking the medication with enough water or not remaining upright for at least 30 minutes after taking it. Correcting these issues can help reduce heartburn and improve the medication’s effectiveness.

Choice D reason: Advising the client to go to the nearest emergency department is not necessary unless the heartburn is severe or accompanied by other symptoms such as chest pain or difficulty swallowing. Initially, it is more appropriate to assess the client’s administration technique and provide guidance on proper medication use.

Choice A reason: Denying having coughing spells indicates that the antitussive medication benzonatate is effective. Benzonatate works by numbing the throat and lungs, reducing the cough reflex. This means that if the client is no longer experiencing coughing spells, the medication is performing its intended function.

Choice B reason: Being able to sleep through the night can be an indirect indicator of the medication’s effectiveness, but it is not as specific as denying coughing spells. While improved sleep might result from reduced coughing, it could also be influenced by other factors such as overall improvement in the client’s condition or the use of other medications.

Choice C reason: Expectorating bronchial secretions is not a direct indicator of the effectiveness of benzonatate. Benzonatate is an antitussive, meaning it suppresses the cough reflex rather than promoting the expulsion of mucus. Therefore, expectorating bronchial secretions would not be a primary measure of this medication’s effectiveness.

Choice D reason: Reporting reduced nasal discharge is also not a direct indicator of the effectiveness of benzonatate. This medication specifically targets the cough reflex and does not have a significant impact on nasal discharge. Reduced nasal discharge could be due to other factors or treatments.