A nurse is assisting with the care of a client who has hypocalcemia. For which of the following signs should the nurse monitor?

B) "I will keep my house at a cool temperature": This statement indicates a need for further teaching because maintaining a warm environment is recommended for individuals with Raynaud's phenomenon to prevent vasoconstriction and reduce the risk of attacks. Cold temperatures can trigger symptoms in individuals with this condition. Therefore, advising the client to keep their house warm is appropriate and aligns with preventive measures for Raynaud's phenomenon.

A) "I will try to anticipate and avoid stressful situations": Stress management is an essential aspect of managing Raynaud's phenomenon, as stress can trigger vasospasms. Anticipating and avoiding stressful situations can help reduce the frequency and severity of symptoms.

C) "I will complete the smoking cessation program I started": Smoking cessation is crucial for individuals with Raynaud's phenomenon because smoking narrows blood vessels and exacerbates symptoms. Completing a smoking cessation program is a positive step toward reducing the risk of vasospasms.

D) "I will wear gloves when removing food from the freezer": Wearing gloves when handling cold objects, such as food from the freezer, is recommended for individuals with Raynaud's phenomenon to prevent triggering attacks due to exposure to cold temperatures. This statement demonstrates an understanding of preventive measures for managing the condition.

A. Expert opinions: While expert opinions can provide valuable insights, they are considered lower in the hierarchy of evidence. They do not undergo the rigorous testing and peer review that higher levels of evidence, such as systematic reviews and randomized controlled trials, do.

B. Credible websites: Credible websites can be a good source of information, but they are not considered the highest level of evidence. The information on websites can vary greatly in quality and may not be peer-reviewed.

C. Qualitative studies: Qualitative studies can provide in-depth information about specific topics, but they are not considered the highest level of evidence. They often involve smaller sample sizes and do not provide the same level of quantitative data as systematic reviews or randomized controlled trials.

D. Systematic review: This is correct. Systematic reviews are considered the highest level of evidence in the hierarchy. They involve a comprehensive search of multiple databases to identify all relevant studies on a particular topic, followed by a rigorous assessment of the quality of each study. The results are then synthesized to provide a comprehensive overview of the current evidence.