A client with hyperparathyroidism is at risk for developing kidney stones. Which nursing interventions are appropriate for preventing kidney stone formation in this client?(Select All that Apply.)
Encouraging the use of calcium supplements
Encouraging the consumption of oxalate-rich foods
Encouraging a low-calcium diet
Administer oral phosphates as ordered
Increase fluids and fiber
Administer furosemide as ordered
Administer calcium chelators
Encouraging increased fluid intake
Correct Answer : D,E,H
A. Encouraging the use of calcium supplements is incorrect. Clients with hyperparathyroidism often have elevated calcium levels, so increasing calcium intake can worsen hypercalcemia and increase the risk of kidney stones.
B. Encouraging the consumption of oxalate-rich foods is incorrect. Oxalate-rich foods, such as spinach, beets, and nuts, can increase the risk of calcium oxalate stones, especially in individuals with hyperparathyroidism. Therefore, oxalate-rich foods should be avoided.
C. Encouraging a low-calcium diet is incorrect. Although high calcium intake can worsen hypercalcemia, a low-calcium diet is not typically recommended. Instead, the focus should be on maintaining balanced calcium levels, as calcium is still important for overall health.
D. Administer oral phosphates as ordered is correct. Phosphates can help lower calcium levels in the blood by binding to calcium and reducing its absorption, which can help prevent kidney stone formation.
E. Increase fluids and fiber is correct. Increased fluid intake helps dilute urine, reducing the risk of stone formation. Additionally, fiber can promote overall digestive health, which can be helpful for preventing kidney stones.
F. Administer furosemide as ordered is incorrect. Furosemide, a diuretic, increases urine output but does not prevent kidney stones. It may actually increase the risk by causing dehydration, which promotes stone formation.
G. Administer calcium chelators is incorrect. Calcium chelators are not typically used in the prevention of kidney stones caused by hyperparathyroidism, and their use could interfere with necessary calcium levels in the body.
H. Encouraging increased fluid intake is correct. Adequate fluid intake is essential in preventing kidney stones, as it helps dilute urine and reduces the concentration of calcium and other stone-forming substances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Providing mandatory workshops on hospital policies may be necessary for compliance and orientation, but these are not typically focused on personal or professional growth and are less likely to enhance long-term retention.
B. Offering mentorship programs is the most effective strategy for growth and retention. Mentorship provides support, guidance, and professional development opportunities, which are especially valuable for nurses in their early years of practice. It helps build confidence, fosters engagement, and increases job satisfaction.
C. Increasing the frequency of shift rotations can lead to fatigue and dissatisfaction, particularly in early-career nurses who are still adapting to the demands of the job. It’s unlikely to support growth or retention.
D. Implementing stricter supervision protocols may create a controlling environment that undermines trust and autonomy, which could negatively impact morale and retention among new nurses.
Correct Answer is B
Explanation
A. Require staff nurses to demonstrate competency by passing a medication administration examination is incorrect. While testing competency may be part of the solution later, it is not the first step. The CQI process should begin by understanding why errors occurred, not by immediately requiring examinations without understanding the root causes.
B. Review the events leading up to each medication administration error is correct. The first step in a Continuous Quality Improvement (CQI) program should be to gather data and analyze the root causes of the medication errors. By reviewing the events that led to the errors, the committee can identify systemic problems, whether related to processes, communication, or individual actions. This approach helps to focus the improvement efforts on addressing the actual causes of the errors rather than just treating the symptoms.
C. Develop a quality improvement program for nurses involved in medication administration errors is incorrect. Developing a quality improvement program is an important step, but the first step in CQI is to gather and analyze data to identify why errors are occurring. The program should be based on findings from the error reviews.
D. Provide an in-service on medication administration to all the nurses is incorrect. While education and in-service training are useful for improving practice, the first step in CQI is to identify the problem. The committee needs to understand the reasons behind the medication errors before implementing training programs.
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