A nurse is completing a medication history for a client who reports using over-the-counter calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?

Choice A reason: Serum potassium level of 5.5 mEq/L is above the normal range of 3.55.0 mEq/L, but it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can also cause the loss of potassium in the urine, which can lead to hypokalemia, a condition that causes muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should monitor the serum potassium level and administer potassium supplements or potassium sparing diuretics as prescribed to prevent hypokalemia.

Choice B reason: Blood pressure of 130/80 mmHg is slightly above the normal range of 120/80 mmHg, but it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can reduce the fluid volume and the peripheral resistance, which can lower the blood pressure and prevent or treat hypertension, edema, or heart failure. The nurse should monitor the blood pressure regularly and adjust the dose of Lasix as prescribed to maintain a normal blood pressure.

Choice C reason: Serum potassium level of 3.0 mEq/L is below the normal range of 3.55.0 mEq/L, and it is a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can also cause the loss of potassium in the urine, which can lead to hypokalemia, a condition that causes muscle weakness, cramps, arrhythmias, or cardiac arrest. The nurse should notify the health care provider immediately and prepare to administer interventions such as potassium supplements or potassium sparing diuretics to correct hypokalemia.

Choice D reason: Serum sodium level of 140 mEq/L is within the normal range of 135145 mEq/L, and it is not a concern for the client taking Lasix, which is a medication that increases the urine output and lowers the blood pressure by inhibiting the reabsorption of sodium and water in the kidney. Lasix can cause the loss of sodium in the urine, which can lead to hyponatremia, a condition that causes confusion, seizures, coma, or death. The nurse should monitor the serum sodium level and administer sodium supplements or fluids as prescribed to prevent hyponatremia.

Choice A reason: This is incorrect. Taking an antacid with another antacid is redundant and unnecessary. Antacids are medicines that neutralize the acid in the stomach and relieve symptoms of heartburn, indigestion, and gastric ulcers. Taking too much antacid can cause side effects such as diarrhea, constipation, or electrolyte imbalance¹.

Choice B reason: This is incorrect. Taking an antacid as needed to reduce pain is not a good practice. Antacids are not painkillers and do not address the underlying cause of gastric ulcers. Gastric ulcers are sores in the lining of the stomach that can be caused by infection, inflammation, or erosion. Taking an antacid may temporarily relieve the pain, but it does not heal the ulcer or prevent complications. Antacids should be taken regularly as prescribed by the doctor, along with other medicines that treat the cause of the ulcer.

Choice C reason: This is correct. Taking an antacid after taking a proton pump inhibitor (PPI) is a good practice. PPIs are medicines that reduce the production of acid in the stomach and help heal gastric ulcers. However, PPIs may take several hours to work and may not provide immediate relief of symptoms. Taking an antacid after a PPI can help neutralize any remaining acid in the stomach and provide faster symptom relief. However, the antacid should be taken at least 2 hours after the PPI, as the antacid can interfere with the absorption of the PPI.

Choice D reason: This is incorrect. Reducing fluid intake with an antacid is not a good practice. Fluid intake is important for hydration, digestion, and elimination. Reducing fluid intake can cause dehydration, constipation, or kidney problems. Fluid intake does not affect the effectiveness of antacids, as long as the antacid is taken with a glass of water to help dissolve and flush it down the esophagus and into the stomach.