The nurse is caring for a patient diagnosed with asthma on a medical surgical unit. The nurse is concerned when the patient makes the following statement after completing their Albuterol nebulizer treatment:

Choice A reason: This is correct. Drinking a glass of water after taking calcium carbonate antacid can help flush the medication down the esophagus and into the stomach, where it can neutralize the excess acid. It can also prevent the medication from sticking to the esophagus and causing irritation or damage¹.

Choice B reason: This is incorrect. Decreasing bulk in the diet is not necessary when taking calcium carbonate antacid. In fact, increasing fiber intake can help prevent constipation, which is a common side effect of calcium carbonate antacid. Constipation occurs because calcium carbonate can reduce the motility of the gastrointestinal tract.

Choice C reason: This is incorrect. Taking the medication with dairy products can decrease absorption and effectiveness of calcium carbonate antacid. Dairy products contain calcium, which can bind to calcium carbonate and form insoluble complexes that are not absorbed by the body. This can reduce the amount of calcium carbonate available to neutralize the stomach acid.

Choice D reason: This is incorrect. Reducing sodium intake is not related to taking calcium carbonate antacid. Sodium is a mineral that regulates fluid balance, blood pressure, and nerve and muscle function in the body. Some medications, such as diuretics, can increase sodium excretion and require the patient to limit sodium intake. Calcium carbonate antacid is not one of them.

Choice A reason: Advise the client to avoid highfiber foods with the medication is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix 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 does not interact with highfiber foods or affect the digestion directly. Highfiber foods can actually help prevent or treat constipation, which can be a side effect of Lasix. The nurse should encourage the client to eat a balanced and nutritious diet, unless they have any dietary restrictions or allergies.

Choice B reason: Encourage the client to consume a potassium rich diet is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix 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 potassiumsparing diuretics as prescribed to prevent hypokalemia. Consuming a potassium rich diet may not be sufficient or safe to correct the potassium imbalance caused by Lasix, especially in clients with kidney impairment or other medications that affect the potassium level.

Choice C reason: Assess the client’s respiratory rate and oxygen saturation is the most appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix 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 help reduce the fluid overload and congestion in the lungs, which can cause shortness of breath, difficulty breathing, fatigue, and low oxygen levels in clients with heart failure. The nurse should assess the client’s respiratory rate and oxygen saturation to evaluate the severity of the pulmonary edema and the effectiveness of the Lasix therapy. The nurse should also monitor the client’s vital signs, fluid intake and output, and weight to ensure adequate fluid balance and hemodynamic stability.

Choice D reason: Instruct the client to increase fluid intake to prevent dehydration is not an appropriate intervention for a nurse to perform prior to administering Lasix to a client with heart failure. Lasix 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 dehydration, which can lead to symptoms such as thirst, dry mouth, dark urine, and fatigue. However, increasing fluid intake to prevent dehydration can worsen the fluid overload and congestion in the lungs, which can cause shortness of breath, difficulty breathing, fatigue, and low oxygen levels in clients with heart failure. The nurse should advise the client to drink enough fluids to maintain hydration, but not to exceed the prescribed fluid restriction, which is usually around 1.52 liters per day. The nurse should also educate the client about the signs and symptoms of dehydration and fluid overload, and when to seek medical attention.