A nurse is planning care for a client with hypocalcemia. Which of the following interventions should the nurse include in the plan?

• Choice A reason:

• Administering calcium supplements orally or IV is not an appropriate intervention for a client with hypocalcemia. Calcium supplements can cause hypercalcemia, which can lead to cardiac arrhythmias, kidney stones, and constipation. Calcium supplements should only be given if the hypocalcemia is severe or symptomatic and under the supervision of a physician.

• Choice B reason:

• Monitoring the client for signs of tetany and seizures is an appropriate intervention for a client with hypocalcemia. Hypocalcemia can cause increased neuromuscular excitability, which can manifest as muscle spasms, cramps, twitching, or convulsions. Tetany is a condition where the muscles contract involuntarily and can affect the hands, feet, face, or larynx. Seizures are a result of abnormal electrical activity in the brain that can be triggered by low calcium levels. The nurse should monitor the client for these signs and intervene promptly to prevent complications.

• Choice C reason:

• Providing a high-phosphorus diet is not an appropriate intervention for a client with hypocalcemia. Phosphorus and calcium have an inverse relationship in the body, meaning that when one is high, the other is low. A high-phosphorus diet can lower the serum calcium level further and worsen the hypocalcemia. The nurse should advise the client to avoid foods high in phosphorus, such as dairy products, meat, poultry, fish, eggs, nuts, seeds, beans, and cola drinks.

• Choice D reason:

• Avoiding stimulating the facial nerve is not an appropriate intervention for a client with hypocalcemia. Stimulating the facial nerve can elicit a positive Chvostek's sign, which is a facial twitching that occurs when the nerve is tapped near the ear. A positive Chvostek's sign indicates hypocalcemia and increased neuromuscular irritability. However, avoiding stimulating the facial nerve does not prevent or treat hypocalcemia. The nurse should monitor the client for other signs of hypocalcemia and administer calcium as prescribed.

Choice A reason:

Administering hypertonic saline solution IV is not appropriate for a client with hypernatremia, because it will increase the serum sodium level and worsen the condition. Hypertonic saline is only used in severe cases of hyponatremia, when the serum sodium level is very low.

Choice B reason:

Encouraging the client to drink caffeinated beverages is not helpful for a client with hypernatremia, because caffeine can act as a diuretic and cause further fluid loss and dehydration. The client should be encouraged to drink water or hypotonic fluids to dilute the sodium concentration in the blood.

Choice C reason:

Monitoring the client's serum sodium level is the correct action for the nurse to take, because it will help to evaluate the effectiveness of the treatment and detect any changes in the client's condition. The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L) The nurse should monitor the client's serum sodium level frequently and report any abnormal values to the provider.

Choice D reason:

Increasing the client's sodium intake is contraindicated for a client with hypernatremia, because it will raise the serum sodium level and aggravate the symptoms. The client should avoid foods high in sodium, such as processed meats, cheese, canned soups, and salty snacks.