Which statement, if made by an older client diagnosed with urinary incontinence, indicates a need for further teaching?

The client should not eat anything before the barium enema, as this could interfere with the visualization of the colon. The client should also take a laxative and an enema the night before the test to clear the bowel of any fecal matter.

Choice B is wrong because the client may need to have laxatives to expel the barium after the test, not before. Barium can cause constipation and impaction if not eliminated promptly.

Choice C is wrong because the client will receive the barium prior to the study by rectum, which is correct. The barium is a contrast agent that helps outline the colon on X-rays.

Choice D is wrong because the client will need to lie down during the study while retaining the barium for X-rays, which is correct. The client may also be asked to change positions to allow different views of the colon.

Take this medication at least 30 minutes before ingesting any food or medication.

This is because alendronate (Fosamax) is a bisphosphonate that works by inhibiting the breakdown and reabsorption of bone. However, it has a very low bioavailability, which means that only a small amount of the drug is absorbed into the bloodstream when taken orally. Therefore, taking it with food or other medications can interfere with its absorption and reduce its effectiveness.

The other choices are wrong because:

A. Chew the tablet well and report any difficulty swallowing. This is wrong because alendronate tablets should not be chewed or crushed, but swallowed whole with a full glass of plain water. Chewing or crushing the tablets can increase the risk of irritation or damage to the esophagus (the tube that connects the mouth to the stomach). Difficulty swallowing is a possible side effect of alendronate and should be reported to the doctor, but it is not an instruction for taking the medication.

B. Take the medication with six to eight ounces of milk. This is wrong because milk contains calcium, which can bind to alendronate and prevent its absorption. Alendronate should not be taken with any beverages other than plain water.

C. Lie down for 15 to 30 minutes after taking the medication. This is wrong because lying down after taking alendronate can increase the risk of esophageal irritation or

ulceration. Alendronate should be taken in the morning, at least 30 minutes before eating or drinking anything, and the person should remain upright (sitting or standing) for at least 30 minutes after taking it.

Normal ranges for bone density are expressed as T-scores, which compare a person’s bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or above is normal, a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis.