A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Choice A reason:

Requesting a prescription to change the route of administration and use the available heparin is not appropriate. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable on a unit-for-unit basis. They have different pharmacokinetics and dosing requirements. Changing the route without proper guidance can lead to incorrect dosing and potential complications.

Choice B reason:

Calculating and administering the equivalent dose of the available low molecular weight heparin is incorrect. LMWH and UFH have different dosing protocols and are not directly interchangeable. Administering LMWH instead of UFH without proper conversion and guidance can result in inappropriate anticoagulation.

Choice C reason:

Diluting the available heparin in 250 ml of normal saline solution prior to IV administration is not appropriate. The prescription specifies heparin 5000 units IV STAT, which indicates an immediate need for intravenous administration. Diluting and administering it in this manner does not align with the urgency of the order.

Choice D reason:

Advising the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately is the correct action. This ensures that the client receives the prescribed medication in the correct form and dosage as ordered by the healthcare provider. It is crucial to follow the specific instructions for heparin administration to ensure patient safety and effective anticoagulation.

Choice A reason:

Taking cimetidine an hour after antacids is appropriate because antacids can interfere with the absorption of cimetidine. It is recommended to separate the intake of these medications by at least one hour to ensure proper absorption and effectiveness of cimetidine.

Choice B reason:

Decreasing cigarette use to a pack per day is not sufficient for a client with peptic ulcer disease. Smoking has been shown to exacerbate peptic ulcers and hinder their healing process. Complete cessation of smoking is strongly recommended to improve the healing of peptic ulcers and reduce the risk of recurrence.

Choice C reason:

Monitoring for signs of sexual dysfunction is important because cimetidine can cause side effects such as decreased libido and erectile dysfunction. Patients should be aware of these potential side effects and report any issues to their healthcare provider.

Choice D reason:

Notifying the healthcare provider of lethargy is crucial because lethargy can be a sign of a more serious underlying condition or an adverse reaction to the medication. Prompt reporting allows for timely intervention and management.