A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.

Choice A reason: This is incorrect because hypotension is not a common effect of long-term corticosteroid therapy. Corticosteroids can cause fluid retention and sodium retention, which can lead to hypertension, not hypotension.

Choice B reason: This is incorrect because muscle weakness is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause muscle wasting and loss of muscle mass, which can affect the patient's mobility and strength, but not as much as delayed wound healing.

Choice C reason: This is incorrect because osteoporosis is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause bone loss and increased risk of fractures, which can affect the patient's bone health and stability, but not as much as delayed wound healing.

Choice D reason: This is correct because delayed wound healing is the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can impair the inflammatory response and the immune system, which can slow down the healing process and increase the risk of infection. This can affect the patient's recovery time and quality.