護理師為一位開始服用 Risedronate 治療骨質疏鬆的病人進行教學。應包含哪些指導？（選所有適合的）
A nurse is teaching a client who is starting risedronate for osteoporosis. Which instructions should the nurse include? (Select all that apply.)
- ATake the medication with a full glass of water✓ 正解以一杯滿的水送服藥物
- BSit upright for at least 30 minutes after taking the pill✓ 正解服藥後保持坐姿至少30分鐘
- CTake the medication 30 minutes before eating breakfast✓ 正解在吃早餐前30分鐘服用藥物
- DTake the medication with milk to increase calcium absorption以牛奶送服藥物以增加鈣質吸收
- EIf you miss a dose, take two pills the following day如果錯過劑量，隔天服用兩顆藥
Risedronate 屬於雙磷酸鹽類（Bisphosphonates）。這類藥物有兩個照護重點：極差的吸收率與嚴重的食道刺激性。為了確保吸收，必須在早晨空腹、吃任何東西前 30 分鐘服用（C），且只能配白開水（A）。為了防止藥錠逆流導致食道炎或潰瘍，服用後必須維持直立姿勢（坐著或站著）至少 30 分鐘（B）。D 是錯誤的，因為鈣（牛奶）會干擾其吸收。E 是錯誤的，不可自行補服雙倍劑量。此題測試護理師如何透過精確的用藥指導來預防嚴重的物理性組織損傷。藥物安全與姿勢指導在此類藥物中同等重要。
Risedronate, a bisphosphonate, must be taken on an empty stomach with a full glass of plain water to ensure adequate absorption and prevent esophageal irritation. The client should remain upright for at least 30 minutes after ingestion to minimize the risk of reflux and esophageal ulceration. Calcium-rich foods like milk and doubling missed doses are contraindicated as they interfere with absorption or increase toxicity risk.
在美國，對雙磷酸鹽類引發食道癌風險的討論較多，故衛教極度嚴格；台灣病人對此類藥物的依從性常受「需空腹」困擾，護理師需強調「不能再躺回床上睡覺」這點，這是 NCLEX 的經典考點。