The nurse is giving discharge instructions to a client who will be taking an antacid for gastric problems. Which three instructions should be provided to this client? (Select all that apply.)

Antacids are alkaline compounds used to manage dyspepsia and GERD by increasing the gastric pH. Because they alter the gastric environment and contain metallic cations, they frequently interact with the absorption of other medications. Different formulations, such as magnesium or aluminum, can significantly alter bowel motility. A. Antacids can cause diarrhea: Formulations containing magnesium salts act as osmotic laxatives, drawing water into the intestinal lumen. This often results in increased motility and loose stools. Clients should be aware of this potential side effect when choosing specific antacid brands. B. Antacids must be taken with a low-fiber diet: Fiber intake is not restricted during antacid therapy and is generally encouraged to maintain healthy digestion. There is no clinical contraindication for fiber in patients using antacids. Dietary fiber does not interfere with the acid-neutralizing capacity of these drugs. C. Antacids are taken once daily in the morning: Because antacids only neutralize existing acid, they have a short duration of action and are typically taken after meals and at bedtime. They are administered multiple times a day as needed for symptom relief. A single morning dose is insufficient. D. Antacids neutralize hydrochloric acid: The primary pharmacological effect is the chemical reaction between the basic antacid and stomach acid to produce water and salts. This increases the intraluminal pH, which reduces the proteolytic activity of pepsin. This provides immediate, though temporary, relief from burning. E. Antacids decrease absorption of other medications: The change in gastric pH can prevent the dissolution of enteric-coated tablets and alter the ionization of various drugs. Additionally, metallic cations can chelate medications like tetracyclines or fluoroquinolones. Most medications should be taken 1 to 2 hours apart from antacids.