The nurse is caring for a client who works night shift from 22:00 to 06:00 and normally sleeps from 08:00 (8 AM) until 16:00 (4 PM) each day.
The nurse should teach this client to take the prescribed corticosteroid at what time of the day?

The correct answer is c. The importance of consuming adequate amounts of water.

Rationale for Choice A:

• Statement:The need to monitor for systemic side effects.
• Rationale:It's not accurate to prioritize monitoring for systemic side effects when teaching a patient about psyllium (Metamucil).Psyllium is a bulk-forming laxative that primarily acts within the gastrointestinal tract,and systemic side effects are rare.While it's essential to be aware of potential side effects,focusing on them during initial teaching might cause unnecessary anxiety.

Rationale for Choice B:

• Statement:The need to use the dry form of Metamucil to prevent cramping.
• Rationale:This statement is incorrect.It's generally recommended to mix psyllium with water or another liquid before ingestion.Consuming the dry form can increase the risk of choking and might not adequately hydrate stool.

Rationale for Choice C:

• Statement:The importance of consuming adequate amounts of water.
• Rationale:This is the most crucial information to emphasize when teaching about psyllium.Psyllium works by absorbing water and forming a bulky gel that softens stool and promotes bowel movements.Without sufficient water intake,psyllium can cause constipation to worsen or lead to intestinal obstruction.

Rationale for Choice D:

• Statement:The onset of action of 30 to 60 minutes after administration.
• Rationale:This statement is inaccurate.Psyllium is not a fast-acting laxative.It typically takes 12-72 hours to produce a bowel movement.Informing patients about the expected time frame for results is essential to manage expectations and prevent unnecessary medication overuse.

The CTZ has to be stimulated in order for vomiting to occur. The CTZ is located in the area postrema of the medulla oblongata and receives input from various sources, such as the blood, the vestibular system, and the gastrointestinal tract.

Choice A is wrong because the limbic system involves emotion, not vomiting or other forms of GI function.

Choice B is wrong because the hypothalamus regulates various functions such as body temperature, hunger, thirst, and circadian rhythms, but not vomiting.

Choice D is wrong because the medulla oblongata is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting, but it is not the site of stimulation for vomiting.

The medulla oblongata contains the vomiting center, which receives signals from the CTZ and other sources and initiates the act of vomiting.