A nurse is assessing a client who has a calcium deficiency. The nurse should identify that the client is at risk for which of the following conditions?

A. A client who has gastroenteritis and is lethargic and confused: Lethargy and confusion indicate significant fluid and electrolyte imbalances, possibly severe dehydration, which can rapidly become life-threatening. Gastroenteritis can cause profound fluid loss, and these neurological changes suggest urgent intervention is needed to prevent shock or other complications.

B. A client who has cystic fibrosis, has a thick, productive cough and reports thirst: Thick secretions and thirst are expected concerns in cystic fibrosis due to chronic pulmonary involvement and potential dehydration. While important to address, these symptoms are less immediately life-threatening compared to altered mental status.

C. A client who has sickle cell anemia and reports pain 15 min after receiving analgesic: Pain is a common and expected symptom in sickle cell crises. The client may require additional pain management, but this finding does not indicate immediate life-threatening issues. The nurse can prioritize this after addressing the client with altered mental status.

D. A client who has diabetes mellitus and has a morning fasting capillary glucose of 185 mg/dL: This elevated glucose requires monitoring and possible adjustment of treatment but is not acutely life-threatening. Hyperglycemia of this level can be managed according to the provider’s plan, so it is not the highest priority for immediate reporting.

A. Wear an N95 respirator: An N95 respirator is required for airborne precautions, such as with tuberculosis. Neutropenic clients are not at risk for transmitting infections but are highly susceptible to acquiring them, so an N95 is not necessary.

B. Insert an indwelling urinary catheter to monitor urinary output: Invasive devices increase the risk of infection in neutropenic clients. Catheterization should be avoided unless absolutely necessary, as it can introduce pathogens.

C. Monitor the client's vital signs every 8 hr: Neutropenic clients require more frequent monitoring to detect early signs of infection. Waiting 8 hours between assessments may delay recognition of sepsis or other complications.

D. Use a dedicated stethoscope: Using a dedicated stethoscope and other equipment for the neutropenic client helps prevent the transmission of pathogens from other patients. This is a key component of neutropenic (protective) precautions to reduce infection risk.