A nurse is reviewing a client's new prescription for indomethacin 100 mg. PO now, then 50 mg PO TID with food for pain relief. Which of the following actions should the nurse take? (Select all that apply.)

A. Administer the medication as needed: Indomethacin is an NSAID (nonsteroidal anti-inflammatory drug) used for pain relief and inflammation control. The prescribed dosage is 100 mg PO initially, followed by 50 mg PO TID (three times a day) with food. The nurse should administer the medication according to this schedule, ensuring the client takes the medication as prescribed to achieve optimal pain relief. The phrase "as needed" should be clarified here. It means the nurse should follow the specific dosing schedule provided in the prescription, ensuring that the medication is taken as prescribed, and not on an "as needed" basis unless stated otherwise by the healthcare provider. B. Administer the medication twice daily: This is incorrect. The prescription specifically calls for indomethacin to be administered 100 mg PO initially, then 50 mg PO three times daily (TID), not twice daily. It is important to follow the prescribed frequency for optimal therapeutic effectiveness and to avoid potential underdosing, which could lead to inadequate pain relief. C. Administer a loading dose of 106 mg PO: This is not correct. A loading dose is typically used when an initial higher dose is needed to quickly achieve therapeutic levels. The prescribed dose for this client is 100 mg initially, followed by 50 mg TID, which is a standard dosing regimen for indomethacin. A loading dose of 106 mg is not appropriate here, as the prescribed dose is already clearly outlined. D. Administer the medication 2 hr after meals: Indomethacin should be taken with food to reduce gastrointestinal irritation, a common side effect of NSAIDs. However, taking the medication 2 hours after meals is appropriate because it helps to ensure that the food is already processed in the stomach, and the medication can be absorbed effectively without causing irritation. Administering the medication immediately after a meal can still cause stomach upset, so spacing it out is often recommended. E. Administer the medication with a snack: It is appropriate to administer indomethacin with food or a snack, as this helps to minimize gastric irritation, which is a common side effect of NSAIDs. Giving the medication with a snack is acceptable as long as the food helps buffer the stomach lining and reduces potential gastrointestinal side effects.