Which instruction should the nurse include when teaching a patient about the medication alendronate (Fosamax)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. Report new or worsening heartburn and difficult or painful swallowing.
2. Take the medication with orange juice 1 hour after eating.
3. Do not lie down for 30 minutes after taking the medication.
4. Take vitamin C supplements as instructed for bone mineralization.
5. Chew the medication well before swallowing.
1,3
Rationale 1: New or worsening heartburn and difficult or painful swallowing are adverse reactions to the medication.
Rationale 2: Alendronate should be administered with water 30 minutes before eating or taking other medications.
Rationale 3: Lying down within 30 minutes of ingestion of the medication may precipitate adverse gastrointestinal reactions.
Rationale 4: Vitamin D supplements should be taken as well as calcium, not vitamin C.
Rationale 5: The medication should not be chewed.
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