A nurse is providing discharge teaching to a client who has hypocalcemia. Which of the following statements by the client indicates understanding of the teaching?

"I should report any tingling I feel around my mouth."

"I should take a 2,500-milligram calcium supplement every day."

"I should avoid dairy products, including cheese."

"I should expect my blood pressure to be very low."

Answer and Explanation

The Correct Answer is A

A. "I should report any tingling I feel around my mouth. Tingling around the mouth, known as perioral paresthesia, is a classic symptom of hypocalcemia and can indicate worsening calcium deficiency or the onset of tetany. This symptom must be reported immediately because it suggests neuromuscular irritability that can progress to serious complications like laryngospasm or seizures if left untreated.
B. "I should take a 2,500-milligram calcium supplement every day." A daily calcium supplement of 2,500 mg exceeds the recommended upper limit for most adults, which is about 2,000 mg per day from supplements. Excessive calcium intake can lead to hypercalcemia, kidney stones, and other complications. Supplement dosage should be based on individual needs and prescribed by a healthcare provider.
C. "I should avoid dairy products, including cheese: Dairy products such as cheese, milk, and yogurt are rich sources of dietary calcium. Avoiding them would reduce calcium intake, which is counterproductive for a client with hypocalcemia. Unless contraindicated due to lactose intolerance or allergies, these foods are encouraged to help manage low calcium levels.
D. "I should expect my blood pressure to be very low." Hypocalcemia does not typically result in very low blood pressure. In fact, it more commonly causes neuromuscular symptoms such as muscle cramps, tetany, and tingling sensations. Low calcium levels may have some cardiovascular effects, but persistent hypotension is not a hallmark feature of hypocalcemia.

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Correct Answer is C

Explanation

A. "Make sure to drink water with your meals." While staying hydrated is important for metabolism and satiety, emphasizing water intake with meals over other proven strategies, like portion control and meal timing, may not be the most effective behavioral focus for weight loss education.
B. "Meal replacement shakes can cause weight gain." Stating that meal replacement shakes can cause weight gain can be misleading. Weight gain typically occurs when total caloric intake exceeds expenditure, regardless of whether calories come from shakes or food.
C. "Your biggest meal of the day should be breakfast." Eating a larger breakfast can promote weight loss by jump-starting metabolism and reducing overall calorie intake later in the day. Front-loading calories earlier in the day can improve satiety and energy levels, leading to healthier eating patterns and potentially better adherence to weight loss goals.
D. "Set your weight loss goal to 2.5 pounds per week." A safe and sustainable weight loss goal is typically 1 to 2 pounds per week. A goal of 2.5 pounds per week may be too aggressive and unrealistic for most individuals, increasing the risk of muscle loss, nutritional deficiencies, or rebound weight gain. Encouraging gradual, steady weight loss supports long-term success.

A. "Provide a small feeding just before bedtime." B. "Position the newborn at a 20-degree angle after feeding." C. "Place the newborn in a side-lying position if vomiting." D. "Dilute formula with 1 tablespoon of water."

Correct Answer is B

Explanation

A. "Provide a small feeding just before bedtime." Feeding just before bedtime can increase the risk of reflux during sleep due to a full stomach and recumbent positioning. It is better to allow time for digestion before lying down to reduce reflux episodes.
B. "Position the newborn at a 20-degree angle after feeding." Keeping the newborn in an upright or slightly elevated position (typically 20 to 30 degrees) after feeding helps reduce gastroesophageal reflux by using gravity to prevent stomach contents from flowing back into the esophagus.
C. "Place the newborn in a side-lying position if vomiting." Side-lying is not the recommended sleeping or resting position due to the risk of sudden infant death syndrome (SIDS). The safest position for infants is on the back, even if they have reflux.
D. "Dilute formula with 1 tablespoon of water." Diluting formula can lead to electrolyte imbalances and inadequate caloric intake. Formula should be prepared according to manufacturer or provider instructions to ensure nutritional needs are met.

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