Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium carbonate for a patient with chronic kidney disease (CKD)?

A. Creatinine clearance: Creatinine clearance reflects glomerular filtration rate and overall kidney function but does not directly indicate the effectiveness of calcium carbonate therapy. Calcium carbonate is prescribed as a phosphate binder, and its efficacy is assessed by changes in serum phosphate rather than kidney filtration rate. B. Phosphate level: Calcium carbonate binds dietary phosphate in the gastrointestinal tract, reducing absorption and helping to manage hyperphosphatemia, which is common in CKD. Monitoring serum phosphate levels allows the nurse to determine whether the medication is effectively lowering phosphate and preventing complications. C. Blood pressure: Blood pressure management is important in CKD, but calcium carbonate does not directly influence blood pressure. While hypertension can exacerbate kidney disease, changes in blood pressure are not a reliable indicator of calcium carbonate’s therapeutic effect. D. Neurologic status: Neurologic changes can occur in severe electrolyte imbalances or uremia, but they are not specific indicators of calcium carbonate effectiveness. Monitoring neurologic status is important for overall patient safety but does not directly reflect phosphate control achieved by the medication.