Furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

Choice A reason: Assessing the client’s strength in moving and turning in bed is important for overall care, but it is not the primary assessment needed before administering a laxative. This assessment helps in understanding the client’s mobility and risk of pressure ulcers but does not directly relate to the effectiveness or necessity of a laxative.

Choice B reason: Determining the frequency and consistency of bowel movements is crucial before administering a laxative. This assessment provides information on the client’s current bowel function and helps in deciding the appropriate type and dosage of laxative. It ensures that the laxative is necessary and helps prevent complications such as diarrhea or bowel obstruction.

Choice C reason: Observing the skin integrity of the client’s rectal and sacral areas is important for preventing pressure ulcers and maintaining skin health, especially in bedfast clients. However, this assessment is not directly related to the administration of a laxative. It is more relevant to overall skin care and prevention of pressure sores.

Choice D reason: Evaluating the client’s ability to recognize the urge to defecate is important for understanding their bowel habits and potential issues with incontinence. However, it is not the primary assessment needed before administering a laxative. This assessment is more relevant to managing bowel training and incontinence.

Choice A reason: Potassium levels are not directly affected by calcium acetate. Calcium acetate is primarily used to manage hyperphosphatemia in patients with CKD by binding to dietary phosphate and preventing its absorption1. Therefore, a decrease in potassium levels would not indicate the effectiveness of calcium acetate.

Choice B reason: Calcium acetate can actually increase calcium levels in the blood, especially if taken in high doses or if the patient has other sources of calcium intake. Monitoring calcium levels is important to avoid hypercalcemia, but a decrease in calcium levels is not the desired effect of this medication.

Choice C reason: Calcium acetate is used to reduce serum phosphate levels in patients with CKD. It works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble calcium phosphate, which is then excreted in the stool. A decrease in serum phosphate levels indicates that the medication is effectively reducing phosphate absorption and managing hyperphosphatemia.

Choice D reason: The pH level of the blood is not directly influenced by calcium acetate. While maintaining acid-base balance is important in CKD management, the primary goal of calcium acetate therapy is to control phosphate level. Therefore, changes in blood pH are not a measure of the medication’s effectiveness.