Final answer:
Further discussion is needed when the client mentions taking an antacid with naproxen, as this could mask more serious side effects like gastrointestinal ulcers. Advising against crushing the medication, if it's an extended-release form, is also an important consideration. 4) "The naproxen is easier to take when I crush it and put it in applesauce."
Step-by-step explanation:
The client's comment that requires further discussion by the nurse is: "I've been taking an antacid to help with indigestion." Naproxen, being a non-steroidal anti-inflammatory drug (NSAID), can increase the risk of gastrointestinal ulcers and bleeding. Taking antacids might temporarily relieve symptoms like indigestion, but it may also mask the more severe side effects of NSAID use, such as stomach ulcers.
Other comments like signing up for a swimming class, losing weight, and crushing the medication to take with applesauce do not immediately raise concerns, assuming that the medication is not of the extended-release variety, in which case crushing it would be inappropriate.
The nurse should provide education about the potential risks associated with the long-term use of NSAIDs, such as stomach ulcers and the danger of kidney damage. Switching to another class of pain relievers or managing indigestion symptoms under medical supervision may be necessary to prevent complications.