What role do the kidneys have in the pharmacokinetics process?

A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.

B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.

C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.

D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."

A) Check the client's perianal skin integrity:
Assessing perianal skin integrity is important in the care of a client with ulcerative colitis, particularly due to the potential for diarrhea and irritation. However, this is not the first priority upon admission for an acute exacerbation.

B) Educate the patient on which foods the patient should eat:
Nutritional education is crucial in managing ulcerative colitis, but it is not the priority during the initial assessment and admission for an acute exacerbation. Stabilizing the client's condition and addressing immediate needs take precedence.

C) Investigate the client's emotional concerns:
While emotional support is important, particularly in chronic conditions like ulcerative colitis, assessing emotional concerns is not the first action required upon admission for an acute exacerbation. Physical stabilization and assessment of the client's condition are the initial priorities.

D) Review the client's electrolyte values:
This is the correct answer. During an acute exacerbation of ulcerative colitis, there is a risk of electrolyte imbalance due to diarrhea and fluid loss. Reviewing the client's electrolyte values is crucial to assess the severity of dehydration and electrolyte imbalances, which can have immediate implications for the client's treatment plan and stabilization.