A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

pH.

Calcium.

Potassium.

Phosphate.

Answer and Explanation

The Correct Answer is D

pH: Calcium acetate is not directly related to changes in blood pH. Therefore, monitoring pH levels would not indicate the effectiveness of the medication for CKD.

B) Calcium: Calcium levels may be affected by calcium acetate, but the primary goal of using calcium acetate in CKD is to reduce phosphate levels, not calcium levels. Therefore, monitoring calcium levels would not directly indicate the effectiveness of the medication.

C) Potassium: Calcium acetate is not typically used to affect potassium levels. Monitoring potassium levels would not indicate the effectiveness of calcium acetate for CKD.

D) Phosphate: This is the correct answer. Calcium acetate is a phosphate binder commonly used in CKD to help lower elevated phosphate levels. A decrease in phosphate levels in the blood would indicate that the medication is having the desired effect in controlling phosphate levels, which is important in managing CKD and preventing complications associated with hyperphosphatemia. Therefore, monitoring phosphate levels is essential to assess the effectiveness of calcium acetate therapy in CKD.

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Correct Answer is C

Explanation

A) Remove the patch and consult with the healthcare provider about the client’s pain resolution: While it’s essential to assess the need for continued pain management, removing the patch without replacing it could lead to inadequate pain control, especially if the client still requires opioid analgesia. Additionally, fentanyl patches are typically left in place for their prescribed duration, and removing them prematurely could disrupt the pain management plan.

B) Place the patch on the client's sh’ulder and leave both patches in place for 12 hours: Applying a new patch without removing the previous one could result in a higher-than-intended dose of fentanyl, increasing the risk of opioid toxicity. Leaving both patches in place simultaneously is not recommended.

C) Apply the new patch in a different location after removing the original patch: This is the correct action. Applying the new patch in a different location helps prevent skin irritation and ensures consistent drug absorption. Rotating patch sites according to the manufacturer's in’tructions is important for optimal medication delivery.

D) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: While oral analgesics may provide temporary relief, they may not be as effective as transdermal fentanyl for managing chronic pain, especially if the client has been on a stable regimen of fentanyl patches. Additionally, delaying the application of the new patch could lead to inadequate pain control.

Correct Answer is ["133"]

Explanation

The nurse should program the infusion pump to deliver approximately 133 ml/hour.

Here's how we can calculate the rate:

Total volume of infusion (mL): 200 mL (dextrose 5% in water)

Infusion time (minutes): 90 minutes

We need to convert the infusion time to hours for the pump rate calculation:

Infusion time (hours) = 90 minutes / 60 minutes/hour

Infusion time (hours) = 1.5 hours

Now, calculate the flow rate (mL/hr):

Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Flow rate (mL/hr) = 200 mL / 1.5 hours

Flow rate (mL/hr) = 133.33 mL/hr (round to nearest whole number as requested)

Therefore, the nurse should program the pump to deliver 133 ml/hour.

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A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to apply the client’s scheduled fentanyl transdermal patch. The nurse notes the previously applied patch is intact on the client’s upper back and the client reports no pain. Which action should the nurse take?

Correct Answer is C

Explanation

Correct Answer is ["133"]

Explanation

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