Clinical context A 72-year-old with osteoporosis is scheduled for the first oral alendronate dose; the nurse reviews swallowing ability, calcium level, fasting instructions, water intake, and ability to remain upright. Which findings or behaviors require clarification before administering oral alendronate? Select exactly 3 responses.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Oral alendronate is contraindicated with esophageal emptying abnormalities, inability to remain upright, and hypocalcemia. It is taken after an overnight fast with plain water and followed by an upright interval.
Quick answer Check esophagus, upright ability, and calcium before alendronate.
Why this is correct Correct administration reduces severe esophageal irritation but does not overcome a contraindication.
Easy analogy or mental picture Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.
Memory hook Drug, urgent cue, protective action, and reassessment endpoint.
NCLEX decision rule Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.
Why the other choices are wrong Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.
References
1DailyMed: Alendronate Sodium TabletsEsophageal and hypocalcemia contraindications plus administration technique
Clinical contextA 72-year-old with osteoporosis is scheduled for the first oral alendronate dose; the nurse reviews swallowing ability, calcium level, fasting instructions, water intake, and ability to remain upright.