A client is using the nasal spray hormone calcitonin to reduce bone loss from osteoporosis. To reduce rhinitis associated with administration of the nasal spray, the nurse should provide the client with which instruction?

A) Administer the scheduled dose: Administering the scheduled dose of warfarin when the INR is 5.0 is not appropriate because this INR level is significantly elevated, indicating a high risk of bleeding. Warfarin dosing should be adjusted based on INR levels to prevent complications such as excessive bleeding.
B) Discontinue the warfarin schedule: Completely discontinuing warfarin may not be necessary unless there are additional factors or signs of bleeding. It is essential to take appropriate action based on the INR level, but discontinuation should be guided by further evaluation and healthcare provider recommendations.
C) Withhold warfarin for 24 hours: Withholding the dose of warfarin is the correct action when faced with an elevated INR of 5.0. This intervention is crucial to prevent potential bleeding complications while waiting for further evaluation and guidance from the healthcare provider regarding additional management, such as administration of vitamin K or other reversal agents.

D) Obtain another INR analysis immediately: While obtaining another INR analysis can be helpful in monitoring trends, it is not the immediate priority if the INR is already 5.0. The primary action should be to withhold the dose and consult with the healthcare provider to determine the appropriate next steps for managing the elevated INR and ensuring patient safety.

A. Phosphate: Calcium acetate is used primarily to manage hyperphosphatemia in patients with chronic kidney disease (CKD). It works by binding to dietary phosphate in the gut, preventing its absorption, which helps lower phosphate levels in the blood. A decrease in phosphate levels indicates that the calcium acetate is effectively controlling phosphate levels.
B. pH: While maintaining normal pH levels is important in CKD, calcium acetate does not directly affect blood pH. The primary role of calcium acetate is to manage phosphate levels rather than pH balance.
C. Calcium: Calcium acetate is a phosphate binder and does not primarily target calcium levels. It can influence calcium levels indirectly, but a decrease in calcium is not the direct measure of the medication's effectiveness. Instead, monitoring phosphate levels is more indicative of the medication’s effectiveness.
D. Potassium: Calcium acetate does not have a direct effect on potassium levels. It is specifically used to manage phosphate levels in CKD patients. Changes in potassium levels would not indicate the effectiveness of calcium acetate.