A nurse is providing discharge teaching to a client who has tuberculosis and is taking rifampin.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale

Magnesium levels within the normal range (1.3 to 2.1 mEq/L) are important for overall electrolyte balance, but sodium polystyrene sulfonate specifically targets potassium. While hyperkalemia can sometimes be associated with other electrolyte imbalances, a normal magnesium level does not directly indicate a therapeutic response to sodium polystyrene sulfonate, as its primary action is not on magnesium.

Choice B rationale

Calcium levels within the normal range (9 to 10.5 mg/dL) are essential for various physiological functions. Sodium polystyrene sulfonate primarily exchanges sodium ions for potassium ions, not calcium. Therefore, a normal calcium level does not reflect a therapeutic response to the medication, which is specifically aimed at reducing elevated potassium levels.

Choice C rationale

Sodium levels within the normal range (136 to 145 mEq/L) are crucial for fluid balance and neurological function. Sodium polystyrene sulfonate exchanges sodium for potassium, meaning it increases the body's sodium load. While a normal sodium level is desirable, it does not directly indicate the therapeutic efficacy of the medication in reducing potassium.

Choice D rationale

Potassium 4.8 mEq/L (3.5 to 5 mEq/L) indicates a therapeutic response. Sodium polystyrene sulfonate is an ion-exchange resin used to treat hyperkalemia by exchanging potassium ions for sodium ions in the gastrointestinal tract. A potassium level returning to within the normal range, from a previously elevated state, signifies that the medication has effectively lowered the excess potassium.

Choice A rationale

Naloxone is an opioid antagonist used to reverse opioid-induced respiratory and central nervous system depression. Midazolam is a benzodiazepine, not an opioid. Therefore, naloxone would not be effective in reversing the adverse effects of midazolam. Its mechanism of action specifically targets opioid receptors.

Choice B rationale

Flumazenil is a benzodiazepine receptor antagonist. It specifically binds to benzodiazepine receptors, competitively inhibiting the effects of benzodiazepines like midazolam. In cases of benzodiazepine overdose or excessive sedation leading to adverse effects such as hypotension, flumazenil can rapidly reverse these central nervous system depressant effects.

Choice C rationale

Moxifloxacin is a fluoroquinolone antibiotic. It is used to treat bacterial infections and has no pharmacological action that would counteract the effects of benzodiazepines or specifically address drug-induced hypotension during a procedure like a colonoscopy. Administering an antibiotic in this scenario would be inappropriate.

Choice D rationale

Fludrocortisone is a mineralocorticoid used primarily for its effects on electrolyte and fluid balance, often in conditions like Addison's disease or orthostatic hypotension. It would not be an appropriate choice for rapidly reversing acute drug-induced hypotension caused by midazolam during a medical procedure. Its action is not immediate.