A nurse is teaching a client who has osteoporosis about calcium supplements. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason:

Potassium is the major cation in the intracellular fluid (ICF), not the extracellular fluid (ECF) It is important for nerve and muscle function, but it does not regulate ECF balance and vascular volume.

Choice B reason:

Calcium is a cation that is mostly found in bones and teeth, but also plays a role in muscle contraction, blood clotting, and enzyme activity. It does not regulate ECF balance and vascular volume.

Choice C reason:

Chloride is the correct answer. It is the major anion in the ECF and it helps to maintain osmotic pressure, acid-base balance, and fluid volume. It often accompanies sodium in fluid replacement therapy.

Choice D reason:

Phosphate is an anion that is mostly found in bones and teeth, but also participates in energy metabolism, acid-base balance, and nucleic acid synthesis. It does not regulate ECF balance and vascular volume.

Choice A reason:

Taking calcium supplements with milk is not recommended because milk contains phosphorus, which can interfere with calcium absorption.

Choice B reason:

Eating spinach while taking calcium supplements is not a problem, as spinach is a good source of calcium and other nutrients. However, spinach also contains oxalates, which can bind to calcium and reduce its absorption. Therefore, spinach should not be the only source of calcium in the diet.

Choice C reason:

Taking calcium supplements with vitamin D is the best option, as vitamin D helps the body absorb and use calcium more effectively. Vitamin D can be obtained from sunlight exposure, fortified foods, or supplements.

Choice D reason:

Limiting caffeine intake while taking calcium supplements is a good idea, but not the most important one. Caffeine can increase calcium excretion in the urine, but this effect can be offset by consuming adequate amounts of calcium from food or supplements.