The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

Promotes stomach emptying and prevents gastric reflux.

Buffers hydrochloric acid and prevents gastric erosion.

Prevents indigestion associated with ingestion of spicy foods.

Binds with phosphorus in foods and prevents absorption.

Answer and Explanation

The Correct Answer is D

Choice A reason: Promoting stomach emptying and preventing gastric reflux is not a relevant action of sevelamer, which is a phosphate binder that lowers serum phosphate levels in patients with CKD. Gastric reflux may be caused by other factors, such as hiatal hernia, obesity, or spicy foods.

Choice B reason: Buffering hydrochloric acid and preventing gastric erosion is not a pertinent action of sevelamer, which does not affect gastric acidity or mucosal integrity. Gastric erosion may be caused by other factors, such as NSAIDs, alcohol, or Helicobacter pylori infection.

Choice C reason: Preventing indigestion associated with ingestion of spicy foods is not a significant action of sevelamer, which does not affect digestion or food tolerance. Indigestion may be caused by other factors, such as overeating, stress, or gallstones.

Choice D reason: Binding with phosphorus in foods and preventing absorption is the correct action of sevelamer, which should be taken with meals to reduce the amount of phosphorus that enters the bloodstream from the diet. High serum phosphate levels can cause bone loss, calcification of soft tissues, and secondary hyperparathyroidism in patients with CKD.

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Correct Answer is B

Explanation

Choice A reason: Increased anxiety and nervousness have been reported by some people taking feverfew, but this is not a common or serious side effect. It may be related to individual sensitivity or dosage.

Choice B reason: Feverfew may interact with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which are commonly used for pain relief. Feverfew and these drugs can both inhibit platelet aggregation and increase the risk of bleeding. This information is most important for the nurse to include in a teaching plan for this client, especially if they are taking any of these medications or have a history of bleeding disorders.

Choice C reason: Those with allergies to chamomile, ragweed, or yarrow should not take feverfew, because they may have a cross-reactivity and experience an allergic reaction to feverfew. This information is important for the nurse to include in a teaching plan for this client, but it is not as critical as choice B.

Choice D reason: Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew, but these are usually mild and transient side effects that do not require medical attention. They may be reduced by taking feverfew with food or water.

Correct Answer is []

Explanation

Potential Condition:Methemoglobinemia

Methemoglobinemia is a condition in which the hemoglobin in the blood is unable to bind oxygen effectively, resulting in tissue hypoxia. It can be caused by exposure to certain drugs or chemicals, such as nitrates, benzocaine, or dapsone. Some symptoms of methemoglobinemia include cyanosis, headache, fatigue, dyspnea, and tachycardia. In severe cases, it can lead to seizures, coma, and death.

Actions to Take:

Draw blood for a complete blood count
administer methylene blue

A complete blood count (CBC) can help diagnose methemoglobinemia by measuring the level of methemoglobin in the blood. A normal level is less than 1%, while a level above 15% can cause symptoms. A level above 30% can be life-threatening. Methylene blue is a medication that can reduce methemoglobin back to normal hemoglobin and restore oxygen delivery to the tissues. It is given intravenously at a dose of 1-2 mg/kg over 5 minutes.

Parameters to Monitor:

Methemoglobin level
heart rate and rhythm

The methemoglobin level is the most important parameter to monitor in methemoglobinemia, as it indicates the severity of the condition and the response to treatment. The goal is to lower the level below 10% or until symptoms resolve. The heart rate and rhythm are also important to monitor, as methemoglobinemia can cause tachycardia and dysrhythmias due to hypoxia and acidosis. The goal is to maintain a normal sinus rhythm and a heart rate within the normal range for the client’s age and condition.

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The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

Correct Answer is B

Explanation

Patient Data Exhibits Review H and P, and nurse’s note. Identify from the choices below which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

Correct Answer is []

Explanation

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