An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

I will withhold the antacid for now, and if you get indigestion, I will bring it back.

CKD stresses your body to over-secrete gastric juices, and antacids help neutralize them.

Your serum phosphate levels are up, and aluminum antacids prevent absorption of phosphates in foods.

OK, I will let your healthcare provider know that you do not need the antacid.

Answer and Explanation

The Correct Answer is C

Choice A: Withholding the antacid until the client gets indigestion is not appropriate because the primary purpose of aluminum hydroxide in CKD is to bind to phosphates in foods and reduce their absorption. It is not primarily used for indigestion.

Choice B: While CKD can lead to disturbances in gastric acid secretion, aluminum antacids are primarily used in CKD to control hyperphosphatemia by binding to phosphates in the gastrointestinal tract. Their role is not primarily related to gastric acid control.

Choice C: This response provides the most appropriate rationale. Aluminum antacids are often prescribed to CKD clients to prevent the absorption of dietary phosphates, which can contribute to hyperphosphatemia in CKD.

Choice D: Simply informing the healthcare provider that the client does not want to take the antacid is not the most informative response, as it does not address the rationale behind the medication use in CKD.

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Correct Answer is B

Explanation

Choice A: Praising the client for weight loss without knowing the underlying cause may not be appropriate. Rapid and unexplained weight loss can be a sign of underlying health issues.

Choice B: Advising the client to schedule an appointment with a healthcare provider is the most appropriate action. Rapid and unexplained weight loss should be evaluated by a healthcare professional to identify any potential underlying health concerns.

Choice C: Advising the client to begin taking a multivitamin daily does not address the underlying cause of the weight loss and may not be the most appropriate action.

Choice D: Documenting the client's reason for using the herb is important but should be accompanied by further evaluation and intervention by a healthcare provider due to the significant weight loss.

A. Offer water to the client hourly. B. Review the intake and output record. C. Increase daily sodium intake. D. Reduce dairy product intake.

Correct Answer is A

Explanation

Choice A: Offering water to the client hourly is an important intervention, especially for older clients who may be prone to dehydration. Confusion can sometimes be a symptom of dehydration, so ensuring adequate hydration is essential.

Choice B: Reviewing the intake and output record is important for assessing the client's fluid balance but may not directly address the client's current confusion.

Choice C: Increasing daily sodium intake would not be appropriate without a specific indication, and it may not address the client's confusion.

Choice D: Reducing dairy product intake is not a standard intervention for confusion and may not be appropriate unless there is a specific dietary restriction or allergy in place.

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An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

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Correct Answer is A

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