Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: The patch
provides baseline therapy, while sublingual nitroglycerin offers rapid symptom relief for acute
episodes. This combination ensures immediate pain control without interrupting ongoing
prophylactic treatment.
The nurse is preparing to administer alendronate to a client with osteoporosis. Which
laboratory value indicates that the nurse should withhold the medication and contact the
healthcare provider?
Reference Range:
- Total Calcium 8.5 to 10.5 mg/dL
- Sodium: 136-145 mEq/L
- Potassium: 3.5 to 5 mEq/L
- Magnesium: 1.3 to 2.1 mEq/L
A. Magnesium 2.4
B. Sodium 132
C. calcium 13.0
D. Potassium 5.2 - CORRECT ANSWER-C.
Calcium 13.0: Alendronate is a bisphosphonate used to treat osteoporosis by inhibiting bone
resorption, which in turn lowers serum calcium levels. Administering alendronate to a client
who is already hypercalcemic could worsen the condition.
Normal Calcium Range Memory Trick:
Calcium = 9 to 10 (alive)
,Alendronate: used for osteoporosis by inhibiting bone breakdown )osteoclasts) and keep
calcium in the bones to increase bone density.
Do not take calcium at the same time as alendronate because calcium blocks absorption of
alendronate.
Alendronate: Take first thing in the morning with a full glass of water only. Stay upright for 30
mins. No food , drinks, or meds.
Calcium: Take later in the day at least 30min - 2 hrs after alendronate.
Hypocalcemia: - CORRECT ANSWER-Can lead to dangerous arrhythmias like torsades de pointes
Calcium controls how strongly and how fast the heart contracts
Hypocalcemia: <8.5 mg/dL: LOW Ca = twitchy
- Tentany
- Muscle cramps
-Positive Chvostek's sign
- Positive Trousseau's sign
- Seizures
Low: Give calcium Gluconate
Hyperccalcemia: - CORRECT ANSWER-High: fluids, diuretics, treat cause
Hypercalcemia >10.5 mg/dL: Everything SLOWS
,- weak muscles
- constipation
- confusion
- Kidney stones
The nurse is teaching a client with Osteoporosis about taking alendronate. Which statement by
the client indicates correct understanding?
A. I will take this medication with milk before bed.
B. I will lie down after taking it to avoid dizziness.
C. I will take it fist thing in the morning with water and stay upright.
D. I will take it with my calcium Supplement for better absorption. - CORRECT ANSWER-C.
Alendronate must be taken first thing in the morning with plain water ONLY and stay upright for
at least 30 mins.
This prevents esophageal irritation and ensures proper absorption.
Incorrect:
Take with milk before bed decrease absorption and lying down after taking it can increase risk of
esophagitis. Taking it with calcium will block absorption.
A client receives a new RX for levothyroxine. Which statement made by the client indicates to
the nurse that education was effective?
A. Administer levothyroxine at bedtime.
B. Take medication on an empty stomach.
, C. Avoid the use of iron supplements.
D. Consume foods that are high in iodine. - CORRECT ANSWER-B.
Levothryoxine is a synthetic T4 (thyroxine) used to treat hypothyroidism. It increase and help
regulate HR, body temperature and energy levels.
- Lifelong therapy (don't stop suddenly)
- Takes weeks to see full effects
- Best indicator of correct dose: Normal TSH
Hypothyroidism symptoms:
- Fatigue
- Weight gain
- Cold intolerance
- Slow heart rate
Levothyroxine reverses these symptoms.
Take medication on an empty stomach: Levothyroxine absorption is optimal when taken on an
empty stomach, ideally 30-60 minutes before breakfast, to avoid binding with food or other
medications.
Levothyroxine is best taken in the morning to mimic the body's natural normal rhythm and to
avoid interference from food.
Avoid the use of iron supplement because iron can interfere with levothyroxine absorption, but
it can be taken if spaced at least 4 hours apart.
provides baseline therapy, while sublingual nitroglycerin offers rapid symptom relief for acute
episodes. This combination ensures immediate pain control without interrupting ongoing
prophylactic treatment.
The nurse is preparing to administer alendronate to a client with osteoporosis. Which
laboratory value indicates that the nurse should withhold the medication and contact the
healthcare provider?
Reference Range:
- Total Calcium 8.5 to 10.5 mg/dL
- Sodium: 136-145 mEq/L
- Potassium: 3.5 to 5 mEq/L
- Magnesium: 1.3 to 2.1 mEq/L
A. Magnesium 2.4
B. Sodium 132
C. calcium 13.0
D. Potassium 5.2 - CORRECT ANSWER-C.
Calcium 13.0: Alendronate is a bisphosphonate used to treat osteoporosis by inhibiting bone
resorption, which in turn lowers serum calcium levels. Administering alendronate to a client
who is already hypercalcemic could worsen the condition.
Normal Calcium Range Memory Trick:
Calcium = 9 to 10 (alive)
,Alendronate: used for osteoporosis by inhibiting bone breakdown )osteoclasts) and keep
calcium in the bones to increase bone density.
Do not take calcium at the same time as alendronate because calcium blocks absorption of
alendronate.
Alendronate: Take first thing in the morning with a full glass of water only. Stay upright for 30
mins. No food , drinks, or meds.
Calcium: Take later in the day at least 30min - 2 hrs after alendronate.
Hypocalcemia: - CORRECT ANSWER-Can lead to dangerous arrhythmias like torsades de pointes
Calcium controls how strongly and how fast the heart contracts
Hypocalcemia: <8.5 mg/dL: LOW Ca = twitchy
- Tentany
- Muscle cramps
-Positive Chvostek's sign
- Positive Trousseau's sign
- Seizures
Low: Give calcium Gluconate
Hyperccalcemia: - CORRECT ANSWER-High: fluids, diuretics, treat cause
Hypercalcemia >10.5 mg/dL: Everything SLOWS
,- weak muscles
- constipation
- confusion
- Kidney stones
The nurse is teaching a client with Osteoporosis about taking alendronate. Which statement by
the client indicates correct understanding?
A. I will take this medication with milk before bed.
B. I will lie down after taking it to avoid dizziness.
C. I will take it fist thing in the morning with water and stay upright.
D. I will take it with my calcium Supplement for better absorption. - CORRECT ANSWER-C.
Alendronate must be taken first thing in the morning with plain water ONLY and stay upright for
at least 30 mins.
This prevents esophageal irritation and ensures proper absorption.
Incorrect:
Take with milk before bed decrease absorption and lying down after taking it can increase risk of
esophagitis. Taking it with calcium will block absorption.
A client receives a new RX for levothyroxine. Which statement made by the client indicates to
the nurse that education was effective?
A. Administer levothyroxine at bedtime.
B. Take medication on an empty stomach.
, C. Avoid the use of iron supplements.
D. Consume foods that are high in iodine. - CORRECT ANSWER-B.
Levothryoxine is a synthetic T4 (thyroxine) used to treat hypothyroidism. It increase and help
regulate HR, body temperature and energy levels.
- Lifelong therapy (don't stop suddenly)
- Takes weeks to see full effects
- Best indicator of correct dose: Normal TSH
Hypothyroidism symptoms:
- Fatigue
- Weight gain
- Cold intolerance
- Slow heart rate
Levothyroxine reverses these symptoms.
Take medication on an empty stomach: Levothyroxine absorption is optimal when taken on an
empty stomach, ideally 30-60 minutes before breakfast, to avoid binding with food or other
medications.
Levothyroxine is best taken in the morning to mimic the body's natural normal rhythm and to
avoid interference from food.
Avoid the use of iron supplement because iron can interfere with levothyroxine absorption, but
it can be taken if spaced at least 4 hours apart.
