Nokea
The nurse is providing education to a group of nursing students regarding the causes of hypercalcemia. Which of the following information should be included? Select all that apply.
- A. hypoparathyroidism.
- B. thiazide diuretics.
- C. malignancy.
- D. end-stage kidney disease.
- E. Crohn's disease.
Correct Answer: B,C,D
Rationale: Thiazide diuretics, malignancy, and end-stage kidney disease cause hypercalcemia by increasing calcium retention or release.
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A client was admitted to the emergency department due to low serum calcium levels. Upon further examination, the client demonstrates carpopedal spasms and reports numbness in their lips and hands. An ECG revealed a prolonged QT interval. Based on this information, the nurse should suspect which condition?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Hyperparathyroidism
- D. Hypoparathyroidism
Correct Answer: D
Rationale: Hypoparathyroidism leads to low serum calcium levels, causing symptoms like carpopedal spasms, numbness, and prolonged QT interval due to decreased parathyroid hormone.
The nurse is caring for a client who was newly prescribed warfarin. Which medication on the client's medication list requires follow-up with the primary healthcare provider (PHCP)?
- A. Loratadine
- B. Saw Palmetto
- C. Furosemide
- D. Pantoprazole
Correct Answer: B
Rationale: Saw Palmetto can interact with warfarin by potentially increasing bleeding risk due to its antiplatelet effects, requiring follow-up with the PHCP. Loratadine (A), Furosemide (C), and Pantoprazole (D) have minimal interactions with warfarin.
The following scenario applies to the next 1 items
The nurse in the emergency department (ED) is caring for a 78-year-old female client
Item 1 of 1
Nurses' Note
1355: Client was brought to the ED by the client's adult children, who reported that while she was visiting, she reported dizziness and seemed slightly confused. The adult child reports that the symptoms started one day ago. The client recently had a change in her blood pressure medication, with the physician increasing the dosage of her prescribed furosemide. Medical history of hypertension, hyperlipidemia, and osteoarthritis. Vital signs: T 100° F (37.8° C), P 104, RR 22, BP 110/66, pulse oximetry reading 95% on room air.
On assessment, the client is lethargic and oriented to person and place, but not time. The client's breathing appears unlabored with tachypnea. Clear lung sounds throughout all lung fields. Skin is warm, dry, and flaky. Peripheral pulses 1+ in all extremities. Aching pain reported in the hips and knees and rated 5 on a scale of 0 (no pain) to 10 (severe pain). Client was ambulated to the bathroom, where she urinated 300 mL of clear, yellow urine without any odor or particulates. 22-gauge peripheral venous access device (VAD) placed in right forearm.
Complete the sentence below by choosing from the list of options. Based on the client's..... and............. this client is at highest risk for........
- A. lung sounds
- B. vital signs
- C. pain level
- D. dosage increase of diuretic
- E. urinary infection.
- F. fluid volume deficit.
Correct Answer: B, D,F
Rationale: Increased furosemide dosage increases the risk of fluid volume deficit, as evidenced by dizziness and lethargy.
The oncoming nurse learns that her new patient is suffering from Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion. Which of the following nursing actions is the most important?
- A. Assess the patient's mental status
- B. Provide oral hygiene
- C. Keep accurate intake and output measurements
- D. Reduce stress and discomfort
Correct Answer: A
Rationale: SIADH causes hyponatremia, which can lead to neurological changes, making mental status assessment critical.
The nurse is teaching a client with hypercalcemia appropriate dietary measures. Which food selections by the client would require follow-up by the nurse? Select all that apply.
- A. broccoli
- B. 2% milk
- C. whole wheat pasta
- D. bananas
- E. seafood
Correct Answer: B
Rationale: Milk is high in calcium and should be limited in hypercalcemia to prevent worsening the condition.