Podcast
Questions and Answers
A client taking bisphosphonates reports persistent muscle and joint pain. Which of the following is the MOST appropriate initial nursing intervention?
A client taking bisphosphonates reports persistent muscle and joint pain. Which of the following is the MOST appropriate initial nursing intervention?
- Recommend the client increase their calcium intake to alleviate the pain.
- Prepare the client for immediate physical therapy.
- Advise the client to take a mild analgesic and report if the pain persists. (correct)
- Instruct the client to discontinue the medication immediately.
A client is prescribed a bisphosphonate. What instruction regarding administration should the nurse emphasize to ensure optimal absorption?
A client is prescribed a bisphosphonate. What instruction regarding administration should the nurse emphasize to ensure optimal absorption?
- Take the medication with a full glass of water and remain upright for 30 minutes. (correct)
- Take the medication with a meal to reduce gastrointestinal upset.
- Take the medication at bedtime to minimize daytime side effects.
- Take the medication with milk to enhance calcium absorption.
Which pre-existing condition would be of MOST concern to the nurse when considering the administration of a bisphosphonate?
Which pre-existing condition would be of MOST concern to the nurse when considering the administration of a bisphosphonate?
- Controlled hypertension.
- Mild seasonal allergies.
- History of migraine headaches.
- Esophageal strictures. (correct)
A client taking bisphosphonates reports new-onset jaw pain. Which of the following is the MOST appropriate action for the nurse to take?
A client taking bisphosphonates reports new-onset jaw pain. Which of the following is the MOST appropriate action for the nurse to take?
A client who is of childbearing age has been prescribed a bisphosphonate. Which of the following instructions is MOST important for the nurse to provide?
A client who is of childbearing age has been prescribed a bisphosphonate. Which of the following instructions is MOST important for the nurse to provide?
A client taking alendronate reports experiencing persistent heartburn and difficulty swallowing. Which of the following is the most appropriate nursing intervention?
A client taking alendronate reports experiencing persistent heartburn and difficulty swallowing. Which of the following is the most appropriate nursing intervention?
A postmenopausal client is prescribed alendronate for osteoporosis. Which instruction should the nurse emphasize regarding medication administration to maximize its effectiveness and minimize adverse effects?
A postmenopausal client is prescribed alendronate for osteoporosis. Which instruction should the nurse emphasize regarding medication administration to maximize its effectiveness and minimize adverse effects?
A client on long-term alendronate therapy is scheduled for a tooth extraction. What is the primary concern the nurse should address with the dentist and the client?
A client on long-term alendronate therapy is scheduled for a tooth extraction. What is the primary concern the nurse should address with the dentist and the client?
Which therapeutic effect should a nurse monitor for in a client receiving alendronate for the treatment of osteoporosis?
Which therapeutic effect should a nurse monitor for in a client receiving alendronate for the treatment of osteoporosis?
A client newly prescribed alendronate reports occasional use of antacids for heartburn. What advice should the nurse provide regarding the timing of antacid administration?
A client newly prescribed alendronate reports occasional use of antacids for heartburn. What advice should the nurse provide regarding the timing of antacid administration?
A client who has been taking alendronate for 5 years reports new onset thigh pain. Which action should the nurse take first?
A client who has been taking alendronate for 5 years reports new onset thigh pain. Which action should the nurse take first?
A male client with age-related osteoporosis is prescribed alendronate. Which of the following pre-existing conditions should the nurse report to the provider before initiating the medication?
A male client with age-related osteoporosis is prescribed alendronate. Which of the following pre-existing conditions should the nurse report to the provider before initiating the medication?
Which statement indicates the client understands instructions on how to properly take alendronate?
Which statement indicates the client understands instructions on how to properly take alendronate?
Flashcards
Bisphosphonates
Bisphosphonates
Medications used to prevent or treat bone loss.
Bisphosphonate Administration
Bisphosphonate Administration
Take with water, sit/stand 30 min, avoid food/supplements for 30 min.
Bisphosphonate Side Effects
Bisphosphonate Side Effects
Muscle/joint pain, jaw pain, swallowing difficulty, vision changes.
Bisphosphonate Contraindications
Bisphosphonate Contraindications
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Bisphosphonate Interactions
Bisphosphonate Interactions
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Bisphosphonates' Uses
Bisphosphonates' Uses
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Prototype Bisphosphonate
Prototype Bisphosphonate
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Bisphosphonates: GI Side Effects
Bisphosphonates: GI Side Effects
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Bisphosphonates: Other Side Effects
Bisphosphonates: Other Side Effects
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Bisphosphonates: Monitoring
Bisphosphonates: Monitoring
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Bisphosphonates: Timing
Bisphosphonates: Timing
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Study Notes
- Bisphosphonates are used for the prevention and treatment of several types of osteoporosis.
- These include postmenopausal osteoporosis, age-related osteoporosis in clients assigned male at birth, and glucocorticoid-related osteoporosis in clients on long-term glucocorticoid therapy.
- Alendronate is the prototype bisphosphonate medication.
Medication Classification
- Bone Resorption Inhibitor.
- Other medications in this category include risedronate, ibandronate, and zoledronate.
Pharmacologic Action
- Bisphosphonates reduce bone resorption by inhibiting osteoclast activity.
Adverse Drug Reactions
- Gastrointestinal disturbances such as esophagitis, nausea, vomiting, and abdominal pain can occur.
- Some clients experience muscle and joint pain, which may require discontinuation of the medication or pain management with a mild analgesic.
- Eye pain and vision changes are possible, but not common.
- Osteonecrosis of the jaw has been reported.
- Bisphosphonates are contraindicated in pregnant or breastfeeding clients due to unknown effects on the fetus or infant.
Interventions
- Monitor for decreased bone resorption to determine the effectiveness of the therapy.
- If clients experience muscle and joint pain, notify the primary care provider.
- Monitor for changes in vision and manifestations of esophagitis.
Safety Alert
- Bisphosphonates can cause ulcerative esophagitis if the medication does not pass completely through the esophagus.
- Clients must take the medication with a full glass of water (6 to 8 oz) and sit or stand for 30 min to ensure it passes into the stomach and dissolves.
Administration
- Give the medication 30 min before other medications, beverages, or food with a full glass of water to prevent esophagitis.
- Clients should remain in a sitting or standing position for 30 min after taking the medication, avoiding food and beverages other than water.
- Administer a mild analgesic for muscle and joint pain.
Client Instructions
- Take the medication with a full glass of water, sit or stand for 30 min.
- Avoid eating or drinking anything other than water for 30 min, and avoid taking calcium supplements or antacids.
- Take a mild analgesic for muscle and joint pain, and report persistent pain.
- Report jaw pain, difficulty swallowing, or changes in vision.
- Discontinue bisphosphonates if pregnancy occurs, noting the potential risk to a developing fetus for years after discontinuation.
Contraindications and Precautions
- Contraindications include esophageal strictures or disorders, difficulty swallowing, inability to sit or stand for 30 min after administration, renal insufficiency, or hypocalcemia.
- Caution should be taken when giving bisphosphonates to clients with upper gastrointestinal disorders, active infection, liver disease, or heart failure.
Interactions
- Calcium supplements and dairy products decrease the absorption of bisphosphonates and should be avoided within 30 min of administration.
Question Answer
- Correct answers for the question includes "Ability to swallow" and "Baseline vision".
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