A client received psyllium this morning. Which assessment finding indicates a therapeutic effect of the medication?

A) The mother should not take any medication while breast feeding in order to prevent harm to the infant: This statement is too restrictive and not accurate. While some medications should be avoided during breastfeeding, many medications can be taken safely in small amounts. The focus should be on which medications are safe for breastfeeding, not a blanket prohibition on all medications. Some medications are compatible with breastfeeding, and the benefits of taking them may outweigh any potential risks.

B) Many medications cross into the breast milk in small amounts and could cause harm to the infant: This statement is correct. While many medications do pass into breast milk in small amounts, it’s important to recognize that some medications can pose risks to the infant depending on the type of medication, dosage, and timing of breastfeeding. Nurses should educate the mother to always consult with a healthcare provider before taking any medication while breastfeeding.

C) While medication can cross into the breast milk, no infants have ever been harmed because of this: This statement is not accurate. While many medications may pass into breast milk in small amounts, there are documented cases of infants being harmed by medications transferred via breastfeeding. It is crucial to be cautious and informed about the safety of medications taken during breastfeeding.

D) It is unlikely that a large enough amount of medication will cross into the breast milk and cause harm to the infant: While it may be true that in many cases, only small amounts of medication pass into breast milk, this statement oversimplifies the issue. The amount and type of medication, as well as the infant’s age, weight, and health, are all factors that need to be considered. Some medications may pose a significant risk to the infant, and careful evaluation is necessary.

A. Sodium: Sodium levels are important to monitor, but in the context of pantoprazole use, abnormal sodium levels are less commonly a direct concern. Pantoprazole primarily impacts the gastric environment rather than fluid or electrolyte balance in a way that would dramatically alter sodium levels.

B. Gastric pH: Pantoprazole works to increase gastric pH by reducing acid secretion, which is its primary therapeutic effect. A higher gastric pH is expected and beneficial in conditions like GERD or peptic ulcers.

C. Calcium: Pantoprazole, when used for extended periods, can interfere with calcium absorption, potentially leading to bone health issues like osteoporosis. However, changes in calcium levels typically do not pose an immediate or life-threatening concern unless significantly low or related to prolonged therapy. It is still something to monitor, but magnesium is a higher priority in this case.

D. Magnesium: Pantoprazole and other proton pump inhibitors (PPIs) are known to cause hypomagnesemia, especially with prolonged use. Low magnesium levels can lead to serious complications, including muscle spasms, seizures, and arrhythmias. Hypomagnesemia is a well-documented side effect of long-term PPI use, making it the most critical lab result to address.