A patient is currently receiving chemotherapy and is experiencing nausea and vomiting. What should the nurse teach the patient to help reduce the nausea and vomiting?

Choice A rationale
This choice is correct. Calcium carbonate, which is used to treat GERD, can lead to hypercalcemia, or high levels of calcium in the blood, if taken in excess or if the client has impaired kidney function. Hypercalcemia can cause various symptoms, including nausea, vomiting, constipation, and abdominal pain. It can also affect the nervous system, leading to confusion, lethargy, and fatigue. In severe cases, it can cause cardiac arrhythmias.
Choice B rationale
Metabolic alkalosis is a condition characterized by a high level of bicarbonate in the blood, leading to an increase in blood pH. While antacids like calcium carbonate can potentially cause metabolic alkalosis if taken in large amounts, it is less likely to occur in patients taking the medication for GERD, as the medication is used to neutralize stomach acid. Therefore, while it’s a potential risk, it’s less likely than hypercalcemia.
Choice C rationale
Hepatotoxicity, or liver damage, is not typically associated with the use of calcium carbonate. This medication does not have a direct effect on the liver, so it’s unlikely to cause hepatotoxicity unless the client has an underlying liver condition or is taking other medications that can cause liver damage.
Choice D rationale
Hyperphosphatemia, or high levels of phosphate in the blood, is not typically a risk associated with the use of calcium carbonate. In fact, calcium carbonate can bind to phosphate in the gut and reduce phosphate absorption, which can help manage high phosphate levels in certain conditions. Therefore, this choice is not the most likely risk for the client.

Choice A rationale
While measuring the correct dosage is an important step in administering nystatin, it is not the first step. The first step should always be to ensure that the medication is properly mixed to ensure an even distribution of the medication.
Choice B rationale
Recording the amount of medication administered is an important step in medication administration, but it is not the first step. The first step should be to ensure that the medication is properly mixed.
Choice C rationale
Instructing the client to swish the nystatin around their mouth is an important part of the administration process, but it is not the first step. The first step should be to ensure that the medication is properly mixed.
Choice D rationale
Vigorously shaking the nystatin bottle is the first step in administering nystatin. This ensures that the medication is properly mixed and that the patient will receive the correct dosage.