A client with rheumatoid arthritis is prescribed ...

[BRWH]

A client with rheumatoid arthritis is prescribed hydroxychloroquine (Plaquenil). The nurse should caution the client to:
 
  1. report blurred vision or decreased reading ability immediately.
  2. continue taking a glass of red wine before dinner to reduce cardiovascular risk.
  3. take this drug with an antacid to decrease stomach distress.
  4. expose skin to sunlight for at least 20 minutes every day to help with bone formation.

Question 2

The nurse is teaching a client about taking risedronate (Actonel) for osteoporosis. Which statement by the client indicates a need for further teaching?
 
  1. I will wait at least 30 minutes before eating.
  2. I will take the medication first thing in the morning, with water.
  3. I can return to bed while I wait for the medication to work.
  4. I will report difficulties with heartburn.

[Bsand8]

Answer to Question 1

Correct Answer: 1
Rationale 1: Blindness can result from retinal damage and is the most serious adverse effect of this medication. Clients should report any indications of visual problems.
Rationale 2: Clients taking hydroxychloroquine should limit or avoid alcohol to reduce the risk of liver damage.
Rationale 3: The client should take antacids only with the approval of the health care practitioner.
Rationale 4: This medication is not used for bone formation.
Global Rationale: Blindness can result from retinal damage and is the most serious adverse effect of this medication. Clients should report any indications of visual problems. Clients taking hydroxychloroquine should limit or avoid alcohol to reduce the risk of liver damage. The client should take antacids only with the approval of the health care practitioner. This medication is not used for bone formation.

Answer to Question 2

Correct Answer: 3
Rationale 1: Food in the stomach interferes with absorption of the medication.
Rationale 2: Bisphosphonates are not well absorbed from the GI tract. Taking them before eating with plain water will allow the best absorption.
Rationale 3: Bisphosphonates can irritate the esophagus, so clients should remain upright for at least 30 minutes after administration to reduce this risk.
Rationale 4: Esophagitis is a serious adverse effect and needs to be reported to a health care provider.
Global Rationale: Bisphosphonates can irritate the esophagus, so clients should remain upright for at least 30 minutes after administration to reduce this risk. Food in the stomach interferes with absorption of the medication. Bisphosphonates are not well absorbed from the GI tract. Taking them before eating with plain water will allow the best absorption. Esophagitis is a serious adverse effect and needs to be reported to a health care provider.

[BRWH]

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[Bsand8]

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