The nurse provides teaching about methotrexate to a client with rheumatoid arthritis. It is most important to address which topic regarding this drug?

Choice A reason: Nucleoside reverse transcriptase inhibitors (NRTIs) are one of the main classes of antiretroviral drugs used in the treatment of HIV. They work by inhibiting the reverse transcriptase enzyme, which is crucial for the replication of the virus. By blocking this enzyme, NRTIs help prevent the virus from multiplying and reduce the viral load in the body.

Choice B reason: RNA transfer inhibitors are not a recognized class of drugs used in the management of HIV. The main classes of antiretroviral drugs include NRTIs, non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors, fusion inhibitors, integrase inhibitors, and entry inhibitors, but RNA transfer inhibitors are not among them.

Choice C reason: Fusion inhibitors are a class of antiretroviral drugs that prevent HIV from entering the host cells. They work by blocking the fusion process between the viral envelope and the host cell membrane, thereby preventing the virus from injecting its genetic material into the host cell. Fusion inhibitors are used as part of combination therapy to manage HIV infection.

Choice D reason: Protease inhibitors are another essential class of antiretroviral drugs used to treat HIV. They work by inhibiting the protease enzyme, which is necessary for the virus to produce mature viral particles. By blocking this enzyme, protease inhibitors prevent the production of functional viral particles, thus reducing the viral load in the body.

Choice E reason: DNA polymerase inhibitors are not used in the management of HIV. They are typically used to treat other viral infections, such as herpesviruses. The management of HIV primarily involves drugs that target the enzymes specific to HIV replication, such as reverse transcriptase, protease, and integrase

Choice A reason: Protein restriction is not a primary treatment for prerenal kidney injury. While managing protein intake can be important in chronic kidney disease to reduce the workload on the kidneys, it is not directly relevant to the acute management of prerenal kidney injury, which primarily involves restoring adequate blood flow to the kidneys.

Choice B reason: Potassium supplementation is not typically necessary for prerenal kidney injury. In fact, in many cases of kidney injury, there is a risk of hyperkalemia (elevated potassium levels) due to reduced kidney function. Therefore, potassium levels need to be monitored, but supplementation is not a standard treatment.

Choice C reason: Fluid administration to increase cardiac output is the appropriate therapy for prerenal kidney injury. Prerenal kidney injury is caused by reduced blood flow to the kidneys, often due to factors like hypovolemia (low blood volume) or heart failure. Administering fluids helps to restore adequate blood flow and perfusion to the kidneys, which can improve kidney function and resolve the prerenal injury.

Choice D reason: Fluid restriction is not appropriate for prerenal kidney injury, which is characterized by reduced blood flow to the kidneys. In cases where hypovolemia or low cardiac output is the cause, restricting fluids would worsen the condition. Instead, increasing fluid intake helps to restore adequate perfusion to the kidneys.