A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.

Choice A reason: Insulin glargine is not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 24 hours and no peak effect. It is used to provide basal insulin coverage and prevent hyperglycemia.

Choice B reason: Regular insulin is the type of insulin to use for diabetic ketoacidosis, as it is a short-acting insulin that has an onset of 30 to 60 minutes and a peak of 2 to 4 hours. It is used to lower the blood glucose level rapidly and correct the acidosis.

Choice C reason: Insulin detemir is also not the type of insulin to use for diabetic ketoacidosis, as it is a long-acting insulin that has a duration of 12 to 24 hours and no peak effect. It is also used to provide basal insulin coverage and prevent hyperglycemia.

Choice D reason: NPH insulin is also not the type of insulin to use for diabetic ketoacidosis, as it is an intermediate-acting insulin that has an onset of 2 to 4 hours and a peak of 4 to 12 hours. It is used to provide intermediate insulin coverage and prevent hyperglycemia.