Which of the following medications would you anticipate being prescribed for the renal failure patient who has hyperphosphatemia?

A. Itching: Pruritus typically develops during the icteric phase of hepatitis when bilirubin accumulates in the tissues. It is not considered an early or prodromal symptom but occurs later as jaundice becomes evident.

B. Vomiting: Nausea and vomiting are common prodromal symptoms of hepatitis due to liver inflammation and its impact on digestion. These gastrointestinal symptoms often occur before jaundice or other late signs become apparent.

C. Fatigue: Fatigue is one of the most frequently reported early symptoms of hepatitis. It results from the body's immune response and reduced liver function and may begin days or weeks before jaundice or dark urine appears.

D. Jaundice: Jaundice typically marks the transition to the icteric phase of hepatitis and follows the prodromal phase. It appears as liver dysfunction progresses and bilirubin accumulates in the bloodstream and tissues.

E. Hyperalgia (increased sensitivity to pain): Increased pain sensitivity, particularly in the upper right quadrant, can occur early in hepatitis due to liver inflammation. This symptom may accompany general malaise and precedes more visible signs like jaundice.

A. 90-year-old female whose blood urea nitrogen (BUN) is rising: An isolated rise in BUN can indicate dehydration, gastrointestinal bleeding, or renal impairment. While BUN may increase slightly with age, a significant rise should not be dismissed as normal aging and warrants further investigation.

B. 81-year-old male whose serum creatinine level has increased sharply since his last blood work: A sharp increase in creatinine is not typical with aging and may suggest acute kidney injury or worsening chronic kidney disease. In older adults, even small creatinine changes can be significant due to reduced muscle mass.

C. 80-year-old male whose dipstick urine reveals protein is present: Proteinuria is not a normal part of aging and may indicate underlying kidney damage, hypertension, or diabetes. Even trace amounts of protein in the urine of older adults should prompt further evaluation to rule out nephropathy.

D. 78-year-old female whose GFR has been steadily declining over several years: A gradual decline in glomerular filtration rate (GFR) is expected with aging due to nephron loss and reduced renal perfusion. This change is a normal physiologic part of aging, provided there are no abrupt drops or accompanying signs of renal disease.