The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

Give sucralfate on an empty stomach.

Assess for secondary Candida infection.

Administer sucralfate once a day, preferably at bedtime.

Monitor for electrolyte imbalance.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct action to include in the client's plan of care, as sucralfate should be given on an empty stomach, at least one hour before meals and at bedtime. Sucralfate is a mucosal protectant that forms a protective barrier over the ulcer and prevents further damage from acid and pepsin. It requires an acidic environment to work, so it should not be taken with food or antacids.

Choice B reason: This is not a relevant action to include in the client's plan of care, as sucralfate does not cause or increase the risk of secondary Candida infection. Candida infection is a fungal infection that can affect the mouth, throat, esophagus, or vagina. It is more common in clients who use antibiotics, corticosteroids, or immunosuppressants, but not sucralfate.

Choice C reason: This is not an accurate action to include in the client's plan of care, as sucralfate should be administered four times a day, not once a day. Sucralfate has a short duration of action, so it needs to be taken frequently to maintain its protective effect on the ulcer.

Choice D reason: This is not a necessary action to include in the client's plan of care, as sucralfate does not cause or affect electrolyte imbalance. Electrolyte imbalance is an abnormality in the levels of sodium, potassium, calcium, magnesium, or other minerals in the blood. It can be caused by dehydration, vomiting, diarrhea, kidney disease, or other conditions, but not sucralfate.

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Correct Answer is C

Explanation

Choice A reason: Determining when the last dose was administered is important to ensure safe and effective pain management, but it is not the first action that the nurse should implement. The nurse should first assess the client's pain level and intensity before deciding on the appropriate dose and frequency of pain medication.

Choice B reason: Encouraging the client to use diversional thoughts to manage pain is a non-pharmacological intervention that can help reduce pain perception and anxiety, but it is not sufficient to address severe or acute pain. The nurse should first assess the client's pain level and intensity before suggesting any complementary or alternative therapies.

Choice C reason: Asking the client to rate the current level of pain using a pain scale is the first action that the nurse should implement, as it can help quantify and communicate the client's pain experience and guide the nurse's decision on pain medication. The nurse should use a valid and reliable pain scale that is appropriate for the client's age, cognitive ability, and language preference.

Choice D reason: Reviewing the history for a past use of recreational drugs is relevant to assess the client's risk of addiction or tolerance to pain medication, but it is not the first action that the nurse should implement. The nurse should first assess the client's pain level and intensity before considering any factors that may influence pain management.

A. Cover your skin before going outside. B. Monitor skin for excessive bruising. C. Limit intake of high-potassium foods. D. Replace salt with a salt substitute.

Correct Answer is C

Explanation

Choice B reason:While spironolactone can sometimes cause side effects, bruising is not a typical issue associated with this medication.

Choice A reason: Covering your skin before going outside is not an instruction that the nurse should include in this client's plan of care, but rather a general precaution that anyone should take to protect their skin from sun damage. Spironolactone does not increase the risk of sunburn or photosensitivity.

Choice C reason:Spironolactone is a potassium-sparing diuretic that works by blocking aldosterone, which helps reduce fluid retention. However, because it spares potassium, there is a risk of hyperkalemia (high potassium levels). Therefore, clients taking spironolactone should limit their intake of high-potassium foods (e.g., bananas, oranges, spinach, avocados) to avoid dangerous potassium levels.

Choice D reason: Replacing salt with a salt substitute is not an instruction that the nurse should include in this client's plan of care, but rather a dangerous practice that can lead to hyperkalemia. Salt substitutes are often made with potassium chloride, which can increase the potassium level in the blood. The client should use herbs or spices instead of salt or salt substitutes to flavor their food.

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