A 65-year-old patient with newly diagnosed multiple myeloma presents with bone pain and fatigue. Which of the following is the most appropriate initial nursing intervention?

Choice A Reason:

Starting the patient on a high-calcium diet is not the most appropriate initial intervention for multiple myeloma. Multiple myeloma often leads to hypercalcemia, a condition where calcium levels in the blood are abnormally high due to bone breakdown. Increasing calcium intake can exacerbate this condition, leading to further complications such as kidney stones and impaired kidney function. Therefore, this choice is not suitable for managing the patient’s immediate symptoms.

Choice B Reason:

Encouraging the patient to increase physical activity to build bone strength is beneficial in the long term but not the most appropriate initial intervention. While weight-bearing exercises can help strengthen bones, they should be introduced gradually and under medical supervision to avoid fractures and other injuries. The immediate priority is to manage the patient’s pain and fatigue effectively.

Choice C Reason:

Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.

Choice D Reason:

Administering prescribed analgesics and educating the patient about pain management strategies is the most appropriate initial intervention. Pain management is a critical aspect of care for multiple myeloma patients, as bone pain is a common and debilitating symptom. Effective pain management improves the patient’s quality of life and allows them to participate in other therapeutic activities. Education on pain management strategies, including the use of medications, physical therapy, and complementary therapies, empowers the patient to manage their symptoms effectively.

Choice A Reason:

A random blood glucose level of 126 mg/dL is not typically indicative of hyperglycemia. Hyperglycemia is generally defined as a blood glucose level above 180 mg/dL. A level of 126 mg/dL is closer to the threshold for diagnosing diabetes but does not necessarily indicate hyperglycemia.

Choice B Reason:

A history of poor wound healing is a common manifestation of hyperglycemia. High blood sugar levels can impair the body’s ability to heal wounds by affecting blood flow and the function of immune cells. This can lead to prolonged wound healing times and an increased risk of infections.

Choice C Reason:

Decreased urinary output is not a typical symptom of hyperglycemia. In fact, hyperglycemia often causes increased urinary output (polyuria) due to the body’s attempt to excrete excess glucose through urine. Decreased urinary output could be indicative of other conditions, such as dehydration or kidney issues.

Choice D Reason:

Clammy skin is more commonly associated with hypoglycemia (low blood sugar) rather than hyperglycemia. Hypoglycemia can cause symptoms such as sweating, shakiness, and clammy skin due to the body’s response to low blood sugar levels. Hyperglycemia, on the other hand, does not typically cause clammy skin.