A nurse is reviewing the laboratory report for a client who has been taking sodium polystyrene sulfonate.
Which of the following findings indicates a therapeutic response to the medication?

Magnesium 1.5 mEq/L (1.3 to 2.1 mEq/L).

Calcium 9.2 mg/dL (9 to 10.5 mg/dL).

Sodium 140 mEq/L (136 to 145 mEq/L).

Potassium 4.8 mEq/L (3.5 to 5 mEq/L).

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is D

Explanation

Choice A rationale

Distribution refers to the reversible movement of a drug from the systemic circulation to the body's tissues. While food can indirectly influence distribution by altering blood flow or protein binding, its primary and most direct impact on drug pharmacokinetics is not typically on the distribution phase itself.

Choice B rationale

Metabolism, primarily occurring in the liver, involves the biochemical modification of drugs. While some foods can induce or inhibit metabolic enzymes, the direct and immediate effect of the presence of food at the time of administration is typically not on the rate of drug metabolism but rather on the initial entry into the systemic circulation.

Choice C rationale

Excretion is the elimination of drugs from the body, mainly through the kidneys. Food generally does not directly influence the rate of drug excretion, which is primarily dependent on renal function, glomerular filtration, tubular secretion, and reabsorption processes.

Choice D rationale

Absorption is the process by which a drug moves from its site of administration into the bloodstream. The presence of food in the gastrointestinal tract can significantly alter the rate and extent of oral drug absorption by affecting gastric emptying time, pH, drug solubility, and interaction with food components.

A. Continue taking ibuprofen for pain relief. B. Crush the medication and mix it with applesauce. C. Take the medication 60 minutes before a meal. D. Insomnia is a common adverse effect of the medication.

Correct Answer is C

Explanation

Choice A rationale

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can exacerbate gastric ulcers by inhibiting prostaglandin synthesis, which normally protects the gastric mucosa. Continuing ibuprofen would counteract the therapeutic effects of esomeprazole, a proton pump inhibitor, and increase the risk of gastrointestinal bleeding and ulcer perforation.

Choice B rationale

Esomeprazole delayed-release capsules contain enteric-coated pellets to protect the active ingredient from gastric acid degradation, allowing absorption in the small intestine. Crushing the medication would destroy this protective coating, leading to premature drug release in the stomach and reduced bioavailability, thereby diminishing its therapeutic efficacy.

Choice C rationale

Esomeprazole is a proton pump inhibitor that irreversibly binds to and inhibits the H+/K+-ATPase pump in gastric parietal cells, thereby reducing gastric acid secretion. Taking it 60 minutes before a meal ensures that peak plasma concentrations coincide with the maximal activity of these pumps, which are stimulated by food intake, optimizing its acid-suppressing effect.

Choice D rationale

While some medications can cause insomnia, it is not a commonly reported adverse effect of esomeprazole. Common adverse effects of proton pump inhibitors typically include headache, nausea, diarrhea, abdominal pain, and flatulence, reflecting their primary actions on the gastrointestinal system and potential systemic effects.

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A nurse is reviewing the laboratory report for a client who has been taking sodium polystyrene sulfonate. Which of the following findings indicates a therapeutic response to the medication?

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A nurse is reviewing the laboratory report for a client who has been taking sodium polystyrene sulfonate.
Which of the following findings indicates a therapeutic response to the medication?