A client with gastroesophageal reflux disorder (GERD), who has been self-medicating with famotidine for the past week, is admitted to the acute care center because the symptoms have worsened. The nurse should anticipate which treatment?

Choice A reason: Denying muscle spasms is normal and not a complication. Muscle twitching indicates hypocalcemia, a thyroidectomy risk due to parathyroid damage. Absence of spasms is reassuring, per postoperative complication monitoring and endocrine surgical care standards in nursing.

Choice B reason: Back and joint pain are nonspecific and not typical thyroidectomy complications. Muscle twitching suggests hypocalcemia, a critical issue post-thyroidectomy. Pain requires assessment but is less urgent, per postoperative monitoring and complication management protocols in surgical nursing.

Choice C reason: Muscle twitching in hands and feet indicates hypocalcemia, a serious complication from parathyroid gland damage during thyroidectomy. This requires immediate calcium replacement to prevent tetany, per postoperative complication monitoring and endocrine surgical care protocols in nursing practice.

Choice D reason: Diaphoresis without headache is nonspecific and not a primary thyroidectomy complication. Muscle twitching signals hypocalcemia, needing urgent intervention. Diaphoresis requires monitoring but is less critical, per postoperative assessment and complication management standards in surgical nursing.

Choice A reason: Withholding the dose delays glucose control, risking hyperglycemia. Obtaining regular insulin ensures accurate dosing, as 70/30 cannot be separated. Timely administration is critical, per diabetes management and insulin therapy protocols in nursing practice for glycemic control.

Choice B reason: Withdrawing regular insulin from a 70/30 vial is impossible, as it’s a fixed mixture. Obtaining a regular insulin vial ensures precise 10-unit dosing, preventing errors, per medication safety and insulin administration standards in diabetes nursing care.

Choice C reason: Pulling 30 units of 70/30 and giving one third is unsafe, as it delivers mixed insulins, not just regular insulin. Obtaining regular insulin ensures accurate dosing, per insulin therapy and patient safety protocols in diabetes management nursing practice.

Choice D reason: Obtaining a new vial of regular insulin ensures the precise 10-unit dose, as 70/30 is a fixed mixture unsuitable for separating regular insulin. This prevents dosing errors, per evidence-based insulin administration and medication safety standards in diabetes nursing care.