Editing Nutrition – RN Practice Questions (section)

==Question 8==
A client with chronic kidney disease is prescribed calcium acetate. When should the nurse instruct the client to take this medication?
# One hour before meals on an empty stomach
# With each meal and snack
# Two hours after meals
# At bedtime with a full glass of water

'''Answer:''' 2. With each meal and snack.

''Rationale:'' Calcium acetate is a phosphate binder. It works by binding dietary phosphorus in the gastrointestinal lumen so that phosphate is excreted in stool rather than absorbed. That chemistry requires the drug and the food to be present in the gut at the same time. Taken before, between, or long after meals, as in options 1, 3, and 4, the binder has no phosphorus to bind and simply delivers a calcium load, leaving the client hyperphosphatemic and at risk for secondary hyperparathyroidism and vascular calcification.