A nurse is caring for a client prescribed Heparin. Which nur… | MyMerci
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Medication AdministrationPPT
Question
A nurse is caring for a client prescribed Heparin. Which nursing action is most appropriate regarding monitoring aPTT levels and preparing protamine sulfate as an antidote?
1Administer sucralfate with the first bite of each meal and at bedtime; give ciprofloxacin immediately after meals to reduce nausea.✓ Correct answer
2Advise the client to use sucralfate solely when heartburn or reflux occurs, as it provides immediate relief and does not require routine dosing.
3Give sucralfate on an empty stomach 1 hour before meals and bedtime; separate ciprofloxacin by at least 2 hours from sucralfate to prevent binding
4If the client has difficulty swallowing, crush sucralfate and mix it with ciprofloxacin oral suspension to administer both medications together as a single dose.
Explanation
When administering Heparin, key nursing considerations include monitoring patient status, checking critical laboratory values, and providing appropriate safety education. Unsafe practices such as stopping medications abruptly or doubling missed doses are incorrect.
Memory Tip Sucralfate = "Suck-up-the-acid, separate 2 hours from other drugs." Also causes constipation (aluminum content).
Clinical scenario
Scenario 50-year-old male with duodenal ulcer on sucralfate 1 g PO QID + ciprofloxacin 500 mg PO BID for cellulitis. Discussion at medication reconciliation.
Key concepts
Sucralfate — Aluminum sucrose octasulfate; forms gel barrier over ulcers; binds many drugs.
Empty stomach administration — 1 hour before meals and HS to maximize ulcer surface coverage.
Drug binding separation — At least 2 hours separation from interacting drugs (fluoroquinolones, levothyroxine).