A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Choice A reason: Potassium levels are not directly affected by calcium acetate. Calcium acetate is primarily used to manage hyperphosphatemia in patients with CKD by binding to dietary phosphate and preventing its absorption1. Therefore, a decrease in potassium levels would not indicate the effectiveness of calcium acetate.Choice B reason: Calcium acetate can actually increase calcium levels in the blood, especially if taken in high doses or if the patient has other sources of calcium intake. Monitoring calcium levels is important to avoid hypercalcemia, but a decrease in calcium levels is not the desired effect of this medication.Choice C reason: Calcium acetate is used to reduce serum phosphate levels in patients with CKD. It works by binding to dietary phosphate in the gastrointestinal tract, forming insoluble calcium phosphate, which is then excreted in the stool. A decrease in serum phosphate levels indicates that the medication is effectively reducing phosphate absorption and managing hyperphosphatemia.Choice D reason: The pH level of the blood is not directly influenced by calcium acetate. While maintaining acid-base balance is important in CKD management, the primary goal of calcium acetate therapy is to control phosphate level. Therefore, changes in blood pH are not a measure of the medication’s effectiveness.