A nurse is caring for a client who has chronic kidney disease (CKD) and states she has heartburn.
The provider prescribes aluminum hydroxide. The client asks, "Why can't I just take the antacid magaldrate my husband has at home?" The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following?
Serum magnesium levels
Serum phosphorus levels
Serum potassium levels
Serum calcium levels
The Correct Answer is B
A. Aluminum hydroxide can lead to increased serum magnesium levels, but this is not the reason for its preference in chronic kidney disease.
B. Aluminum hydroxide is preferred because it binds to dietary phosphate, reducing serum phosphorus levels in patients with chronic kidney disease who are prone to hyperphosphatemia.
C. Aluminum hydroxide does not significantly affect serum potassium levels.
D. Aluminum hydroxide can lead to decreased serum calcium levels due to binding, but this is not the primary reason for its preference in chronic kidney disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Administering corticosteroids is crucial during an Addisonian crisis but typically involves intravenous corticosteroids (not oral) during the crisis to quickly restore hormone levels. Oral corticosteroids are part of regular maintenance therapy but not an immediate intervention in the crisis.
B. Weighing the client daily is important to monitor for potential fluid loss, dehydration, or weight changes related to Addison's disease and Addisonian crisis. Clients with Addison’s disease may experience fluid and electrolyte imbalances, so daily weight tracking helps detect early signs of fluid shifts, which are critical in crisis prevention and management.
C. A low-carbohydrate diet is not recommended for clients with Addison’s disease, as they may need a balanced diet with sufficient carbohydrates to prevent hypoglycemia.
D. Fluid intake should not be restricted; rather, maintaining adequate hydration is vital. Clients in Addisonian crisis are often at risk for dehydration due to fluid losses and low aldosterone levels, making fluid replacement essential.
Correct Answer is C
Explanation
A. Ondansetron is an antiemetic commonly used to prevent nausea and vomiting, and it is not typically associated with nephrotoxicity.
B. Diphenhydramine is an antihistamine used for allergy symptoms and as a sleep aid. It is not known to cause nephrotoxicity.
C. Vancomycin is an antibiotic that can cause nephrotoxicity, especially when administered in high doses or in individuals with impaired renal function. Monitoring renal function is crucial when using vancomycin.
D. Omeprazole is a proton pump inhibitor used to reduce gastric acid secretion and treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. It is not associated with nephrotoxicity.
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