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A patient with chronic kidney disease (CKD) brings all home medications to the clinic to be reviewed by the nurse. Which medication being used by the patient indicates that patient teaching is required?

a. Multivitamin with iron
b. Milk of magnesia 30 mL
c. Calcium phosphate (PhosLo)
d. Acetaminophen (Tylenol) 650 mg

User Sabeer
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1 Answer

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Final answer:

Milk of magnesia 30 mL requires patient teaching when used by a patient with CKD due to the risk of hypermagnesemia and potential kidney injury because of impaired renal magnesium excretion.

Step-by-step explanation:

Among the medications that a patient with chronic kidney disease (CKD) is using, milk of magnesia 30 mL indicates that patient teaching is required. Patients with CKD often have impaired kidney function, which can affect the excretion of electrolytes, including magnesium, phosphate, and potassium. Milk of magnesia contains magnesium, and its use can lead to hypermagnesemia (elevated magnesium levels) in those with reduced renal function. This can further exacerbate kidney injury.

Hyperphosphatemia is a condition associated with CKD due to decreased phosphate excretion. Therefore, care should be taken with the intake of phosphate. Although calcium phosphate (PhosLo) is used to manage high phosphate levels in CKD patients, patient teaching is critical to ensure appropriate use and monitoring.

Acetaminophen (Tylenol) can be used by CKD patients since it's less likely to cause kidney injury compared to nonsteroidal anti-inflammatory drugs (NSAIDs). However, as with all medications in CKD, dosages may need to be adjusted and use should be monitored by a healthcare provider. Multivitamins with iron do not typically cause concern specific to kidney function, provided that iron levels are monitored and over-supplementation is avoided.

User Dan King
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