The nurse is caring for a patient after a barium enema. When assessing the patient's subsequent bowel patterns and stools, what finding will the nurse report to the health care provider?

Choice A reason: Atenolol 25 mg oral tablet with breakfast is a common beta-blocker used to manage heart conditions, but it does not indicate an immediate priority.

Choice B reason: Captopril 25 mg three times a day is an ACE inhibitor used to manage blood pressure and heart failure but is not an immediate priority unless there are contraindications.

Choice C reason: Hydrochlorothiazide 25 mg twice a day is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice D reason: Aspirin 81 mg tablet every day is a common medication for preventing blood clots but is not an immediate priority unless there are contraindications or interactions.

Choice E reason: Digoxin 0.125 mg every other day is used to manage heart conditions but is not the immediate priority unless there are contraindications or interactions.

Choice F reason: Furosemide 20 mg at bedtime is a diuretic used to manage fluid retention and blood pressure. While important, it is not the immediate priority unless there are contraindications.

Choice G reason: Multivitamin one tablet daily is a common supplement and is not the immediate priority.

Choice H reason: Some doses of medication are missing, which needs to be addressed, but it is not the immediate priority.

Choice I reason: Some routes of medications are missing, which needs to be addressed, but it is not the immediate priority.

Choice J reason: Some medications are duplicated, which is important but not the immediate priority unless it poses a risk to the patient.

Choice K reason: The medications have drug-drug interactions is the priority for the nurse to address. Drug-drug interactions can lead to adverse effects and complications, especially in a patient with multiple conditions such as heart failure, asthma, and kidney disease. Ensuring that medications are safe and do not interact negatively is crucial for patient safety.

Choice A reason: Administering phosphate binders with meals is an essential intervention for managing renal osteodystrophy in patients with chronic kidney disease (CKD). Renal osteodystrophy results from an imbalance of calcium and phosphate in the body due to impaired kidney function. Phosphate binders help reduce the absorption of phosphate from the diet, thereby lowering serum phosphate levels and preventing complications such as secondary hyperparathyroidism and bone disorders. This intervention helps maintain the proper balance of minerals, improving bone health and reducing the risk of fractures and other skeletal complications in CKD patients.

Choice B reason: Encouraging the patient to increase potassium-rich foods is not appropriate for managing renal osteodystrophy. Patients with CKD often need to limit their potassium intake because impaired kidney function can lead to hyperkalaemia (elevated potassium levels), which is potentially life-threatening. Instead of promoting potassium-rich foods, the focus should be on controlling phosphate and maintaining calcium levels.

Choice C reason: Monitoring calcium levels for signs of hypocalcaemia is important in CKD management, but it is not the primary intervention for renal osteodystrophy. While hypocalcaemia can occur in CKD due to disrupted vitamin D metabolism, addressing phosphate levels through the use of phosphate binders is a more targeted approach to managing renal osteodystrophy and preventing secondary hyperparathyroidism.

Choice D reason: Increasing fluid intake to 3 litters per day is generally not recommended for CKD patients, especially those with reduced urine output or fluid retention issues. Excessive fluid intake can lead to fluid overload, hypertension, and heart failure in CKD patients. The intervention should focus on phosphate control rather than fluid intake adjustments.