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Difficulty: MediumPharmacological Therapies

A practical nurse (PN) is caring for a client with osteoporosis who is scheduled to receive a weekly dose of oral risedronate. Which of the following actions must the PN take to safely administer this medication and reinforce client teaching? Select all that apply.

  1. Confirm the client's identity using two distinct identifiers prior to providing the medication.Answer
  2. Instruct the client to swallow the tablet whole with a full glass of plain water upon waking.Answer
  3. C
    Administer the medication alongside the client's morning calcium carbonate supplement to maximize bone absorption.
  4. Ensure the client maintains an upright seated or standing posture for at least 30 minutes after taking the dose.Answer
  5. E
    Allow the client to return to a supine position in bed immediately if they report morning fatigue.
  6. F
    Accept a delegated task from the registered nurse to crush the tablet for administration via a nasogastric tube.

Answer

The correct actions include confirming the client's identity with two identifiers, instructing the client to swallow the tablet whole with a full glass of plain water upon waking, and ensuring the client remains upright for at least 30 minutes.
Risedronate is a bisphosphonate that must be taken in the morning on an empty stomach with 6 to 8 ounces of plain water to ensure proper gastrointestinal absorption. The client must remain upright for a minimum of 30 minutes to prevent the tablet from causing severe esophageal irritation or ulceration. Verifying two distinct client identifiers is a universal safety standard for all medication administration.

Step-by-Step Solution

1
Identify the pharmacological classification of risedronate.
Risedronate is recognized as a bisphosphonate used for osteoporosis.
Understanding the drug class dictates the specific administration and monitoring rules.
2
Determine the required safety protocols for bisphosphonate administration.
The medication requires an empty stomach, plain water, and an upright posture post-administration.
These strict parameters prevent poor drug absorption and severe esophageal ulceration.
3
Evaluate the distractors against LPN scope of practice and medication rights.
Identify that crushing the medication, co-administering with calcium, and allowing a supine position violate safe administration principles.
Safe practice requires recognizing dangerous drug interactions and inappropriate delegation.

Key Concept

Bisphosphonate Administration Principles and Scope of Practice
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Topics

Pharmacological Therapies

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