Answer to Question 1
Answer: D
The client with chronic kidney disease is unable to excrete potassium, and therefore the drug sodium polystyrene sulfonate (Kayexalate) is utilized in order to exchange sodium for potassium in the large intestine, resulting in decreased serum potassium levels. Although the client might have increased stools, the therapeutic effectiveness of the drug is measured by monitoring the serum potassium. This drug does not affect either the sodium level or the specific gravity.
Answer to Question 2
Answer: A
The client with chronic kidney disease has elevated phosphate levels due to the inability of the damaged kidney to excrete this electrolyte. Calcium acetate, when given with meals, will bind serum phosphorus and therefore lower the serum level. Calcium acetate has no effect on serum creatinine. Although calcium acetate can act as an antacid and neutralize gastric acid when given between meals, this is not the reason it is given to a client with chronic kidney disease. This medication has no effect on appetite stimulation.
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