What should a nurse do if a client with end-stage renal disease is not achieving the desired outcome from sevelamer?

When managing a client with end-stage renal disease who is not achieving the desired effect from sevelamer, closely monitoring the client’s diet is essential. Sevelamer is a phosphate binder that helps manage hyperphosphatemia by binding dietary phosphate in the gastrointestinal tract. If the client is not experiencing the expected outcomes, it could indicate dietary factors influencing phosphate levels.

By monitoring the client’s diet, the nurse can assess if the client is consuming high-phosphate foods that may not be adequately managed by sevelamer alone. This assessment can guide dietary modifications to better support the medication's effectiveness, ensuring the client adheres to a low-phosphate diet while taking sevelamer.

Adjusting dietary intake can often improve the therapeutic outcomes alongside medication treatment, making this a logical first step in addressing the issue. It encourages a holistic approach to managing the client's condition, focusing not only on pharmacological interventions but also on lifestyle and dietary choices that can significantly impact treatment results.