Podcast
Questions and Answers
A client taking bisphosphonates reports persistent muscle and joint pain despite using mild analgesics. What is the most appropriate nursing action?
A client taking bisphosphonates reports persistent muscle and joint pain despite using mild analgesics. What is the most appropriate nursing action?
- Suggest alternating between different types of over-the-counter analgesics to manage the pain.
- Instruct the client to increase their dosage of the analgesic until the pain subsides.
- Reassure the client that this is a common side effect and will resolve with continued use of the medication.
- Advise the client to report the persistent pain to their primary care provider for further evaluation. (correct)
A client with a history of esophageal strictures is prescribed a bisphosphonate. What is the priority nursing action?
A client with a history of esophageal strictures is prescribed a bisphosphonate. What is the priority nursing action?
- Monitor the client for signs of esophageal irritation after medication administration.
- Ensure the client remains upright for at least one hour after taking the medication.
- Question the prescription with the prescribing health care provider. (correct)
- Administer the medication with a large volume of water to facilitate swallowing.
A client who has been taking bisphosphonates confides to the nurse that they are planning to become pregnant. What is the most appropriate instruction for the nurse to give the client?
A client who has been taking bisphosphonates confides to the nurse that they are planning to become pregnant. What is the most appropriate instruction for the nurse to give the client?
- Discontinue the bisphosphonate immediately and consult their primary care provider due to potential risks to the fetus. (correct)
- Continue taking the bisphosphonate until pregnancy is confirmed by a healthcare provider.
- Switch to a different bisphosphonate that is known to be safe during pregnancy.
- Reduce the dosage of the bisphosphonate by half to minimize potential fetal risks.
A nurse is teaching a client about taking alendronate. Which statement made by the client indicates a need for further teaching?
A nurse is teaching a client about taking alendronate. Which statement made by the client indicates a need for further teaching?
Which assessment finding would be most concerning prior to administering bisphosphonates to a client?
Which assessment finding would be most concerning prior to administering bisphosphonates to a client?
A client taking alendronate reports experiencing persistent heartburn and difficulty swallowing. Which of the following actions is MOST appropriate?
A client taking alendronate reports experiencing persistent heartburn and difficulty swallowing. Which of the following actions is MOST appropriate?
A client is prescribed alendronate for postmenopausal osteoporosis. What information is MOST essential for the nurse to reinforce regarding the administration of this medication?
A client is prescribed alendronate for postmenopausal osteoporosis. What information is MOST essential for the nurse to reinforce regarding the administration of this medication?
Which of the following adverse effects should a nurse MOST closely monitor in a client who is on long-term bisphosphonate therapy?
Which of the following adverse effects should a nurse MOST closely monitor in a client who is on long-term bisphosphonate therapy?
A client with age-related osteoporosis is prescribed risedronate. The nurse understands that the primary mechanism of action of this medication is to:
A client with age-related osteoporosis is prescribed risedronate. The nurse understands that the primary mechanism of action of this medication is to:
A client is receiving zoledronate via IV infusion. Which of the following pre-infusion assessments is MOST important for the nurse to perform?
A client is receiving zoledronate via IV infusion. Which of the following pre-infusion assessments is MOST important for the nurse to perform?
A client on ibandronate reports new onset muscle pain. What is the MOST appropriate initial nursing action?
A client on ibandronate reports new onset muscle pain. What is the MOST appropriate initial nursing action?
A nurse is providing education to a client who is starting alendronate therapy. Which statement by the client indicates a correct understanding of how to take the medication?
A nurse is providing education to a client who is starting alendronate therapy. Which statement by the client indicates a correct understanding of how to take the medication?
A client who is of childbearing age is prescribed alendronate. What is the MOST important question for the nurse to ask before initiating therapy?
A client who is of childbearing age is prescribed alendronate. What is the MOST important question for the nurse to ask before initiating therapy?
Flashcards
What is a bisphosphonate?
What is a bisphosphonate?
A medication used to treat osteoporosis and other bone-related conditions.
Bisphosphonate Administration
Bisphosphonate Administration
Take with water, sit/stand for 30 min, wait 30 min before eating/drinking (except water) or taking calcium/antacids.
Bisphosphonate Side Effects
Bisphosphonate Side Effects
Muscle/joint pain, jaw pain, difficulty swallowing, vision changes.
Bisphosphonate Contraindications
Bisphosphonate Contraindications
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Bisphosphonate Interactions
Bisphosphonate Interactions
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Bisphosphonates
Bisphosphonates
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Bisphosphonates Uses
Bisphosphonates Uses
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Prototype Bisphosphonate
Prototype Bisphosphonate
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Bisphosphonates - Adverse Effects
Bisphosphonates - Adverse Effects
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Bisphosphonates - Monitoring
Bisphosphonates - Monitoring
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Bisphosphonates - Esophagitis Risk
Bisphosphonates - Esophagitis Risk
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Bisphosphonates - Administration
Bisphosphonates - Administration
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Bisphosphonates - Timing
Bisphosphonates - Timing
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Study Notes
- Bisphosphonates treat osteoporosis.
- Bisphosphonates prevent and treat postmenopausal osteoporosis, age-related osteoporosis in clients assigned male at birth, and glucocorticoid-related osteoporosis in clients on long-term glucocorticoid.
- Alendronate is the prototype bisphosphonate medication.
- Bisphosphonates are bone resorption inhibitors.
- Other bisphosphonates include risedronate, ibandronate, and zoledronate.
- Bisphosphonates decrease bone resorption via inhibiting osteoclast activity.
Adverse Drug Reactions
- Bisphosphonates (e.g., alendronate) cause GI disturbances like esophagitis, nausea, vomiting, and abdominal pain.
- Muscle and joint pain may occur, possibly requiring discontinuation or analgesics.
- Eye pain and vision changes are possible.
- Osteonecrosis of the jaw is a reported risk.
- Pregnant or breastfeeding clients should not take alendronate due to unknown effects on the fetus or infant.
Interventions
- Monitor for decreased bone resorption to measure therapy effectiveness.
- Notify the provider for muscle and joint pain management with analgesics.
- Watch vision changes, and monitor for esophagitis.
Safety Alert
- Bisphosphonates can cause ulcerative esophagitis if they do not completely pass into the stomach.
- Clients must take bisphosphonates with 6 to 8 oz of water and sit or stand for 30 minutes.
Administration
- Give bisphosphonates 30 minutes before other medications, beverages, or food, with a full glass of water.
- Clients should remain sitting or standing and avoid consuming anything aside from water for 30 minutes after taking the medication.
- Administer a mild analgesic for muscle and joint pain.
Client Instructions
- Take with a full glass of water, and then sit or stand for 30 minutes, avoid other food, drinks or medications.
- Avoid calcium supplements or antacids for 30 minutes after dose.
- Take a mild analgesic for muscle and joint pain, and report persistent pain.
- Tell your primary care provider about jaw pain, difficulty swallowing, or vision changes
- Discontinue if pregnancy occurs due to fetal risk for years after.
Contraindications and Precautions
- Contraindications include esophageal strictures or difficulty swallowing.
- Avoid in clients unable to sit/stand for 30 minutes, those with renal insufficiency or hypocalcemia, upper gastrointestinal disorders, active infection, liver disease, or heart failure.
Interactions
- Calcium supplements and dairy products decrease bisphosphonate absorption, so avoid within 30 minutes.
Question Answer
- Prior to starting alendronate, the nurse should assess the client's ability to swallow and baseline vision.
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Description
Bisphosphonates treat osteoporosis by inhibiting osteoclast activity and decreasing bone resorption. Medications like alendronate are used to prevent and treat osteoporosis in postmenopausal women, age-related cases in men, and glucocorticoid-related osteoporosis. Monitor for GI disturbances and muscle pain.
