The nurse teaches the client with chronic renal failure when to take the aluminum hydroxide gel. Which of the following statements would indicate that the client understands the teaching?
A. “I’ll take it every four (4) hours around the clock.”
B. “I’ll take it between meals and at bedtime.”
C. “I’ll take it when I have a sour stomach.”
D. “I’ll take it with meals and bedtime snacks.”
Correct Answer: D. “I’ll take it with meals and bedtime snacks.”
Aluminum hydroxide gel is administered to bind the phosphates in ingested foods and must be given with or immediately after meals and snacks. Aluminum hydroxide when used as an antacid is to be delivered orally. Shake the aluminum hydroxide suspension well before use. It should be taken 5 to 6 times daily after meals and at bedtime, not to exceed 3.84 g per 24 hours. The patient should follow the dose with water intake.
Option A: There is no need for the client to take it on a 24-hour schedule. When administering aluminum hydroxide as an antacid, the patient should have monitoring of their calcium and phosphate plasma concentrations. Kidney function also requires monitoring, especially with prolonged use of aluminum hydroxide.
Option B: It is not prescribed between meals. Patients should be asked about any kidney issues before aluminum hydroxide administration, as these outcomes have strong correlations with aluminum hydroxide’s use as a phosphate binder in patients on dialysis.
Option C: It is not administered to treat hyperacidity in clients with CRF. Prolonged administration should not be considered in a patient with renal impairment or a patient on dialysis, as impaired clearance of excess aluminum may precipitate the drug’s adverse effects.
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