The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

Choice A reason: This is not the laboratory finding that indicates that the medication has been effective. Serum ammonia level of 30 Mcg/dL (17.62 mmol/L) is within the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate is a cation-exchange resin that binds to potassium in the intestine and removes it from the body through the stool. It does not affect the ammonia levels in the blood, which are influenced by the liver function and the urea cycle. The nurse should monitor the ammonia levels for any changes, but it is not the goal of the medication.

Choice B reason: This is not the laboratory finding that indicates that the medication has been effective. Hemoglobin level of 13.5 g/dL (135 g/L) is within the normal range for females, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the hemoglobin levels in the blood, which are determined by the number and size of red blood cells and the oxygen-carrying capacity of the blood. The nurse should monitor the hemoglobin levels for any changes, but it is not the goal of the medication.

Choice C reason: This is the laboratory finding that indicates that the medication has been effective. Serum potassium level of 3.8 mEq/L (3.8 mmol/L) is within the normal range for adults, and it indicates that the medication has lowered the potassium levels in the blood. Sodium polystyrene sulfonate is used to treat hyperkalemia, or high potassium levels, which can occur in AKI due to the impaired renal excretion of potassium. Hyperkalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. The nurse should administer sodium polystyrene sulfonate as prescribed and check the serum potassium levels regularly to ensure that they are within the normal range.

Choice D reason: This is not the laboratory finding that indicates that the medication has been effective. Serum glucose level of 120 mg/dL (6.7 mmol/L) is slightly above the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the glucose levels in the blood, which are influenced by the carbohydrate metabolism and the insulin secretion and action. The nurse should monitor the glucose levels for any changes, but it is not the goal of the medication.

Choice A reason: This is not an appropriate action for the nurse to take. Increasing the intake of saturated fats will worsen the side effects of orlistat, which inhibits the absorption of fats in the intestine. The client should be advised to follow a low-fat diet while taking orlistat.

Choice B reason: This is not an appropriate action for the nurse to take. Oily stools and flatus are common and expected side effects of orlistat, and they do not indicate a serious adverse reaction. The client does not need to stop taking the drug or contact her healthcare provider unless the symptoms are severe or persistent.

Choice C reason: This is not an appropriate action for the nurse to take. Obtaining a stool specimen to evaluate for occult blood and fat content is not necessary for a client taking orlistat. The presence of fat in the stool is normal and expected with orlistat, and there is no evidence of bleeding in the client's case.

Choice D reason: This is the appropriate action for the nurse to take. Asking the client to describe her dietary intake history for the last several days will help the nurse assess the client's compliance with the recommended low-fat diet and provide education and counseling as needed. The nurse can also monitor the client's weight loss progress and adjust the dosage of orlistat accordingly.