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. 120 mL (4 oz) sugar-free soda: Sugar-free soda does not contain carbohydrates or glucose, which are necessary to treat hypoglycemia. It is sweetened with artificial sweeteners that do not raise blood glucose levels. Offering this would not correct a hypoglycemic episode and could result in worsening symptoms.
B. Three saltine crackers:Three saltine crackers contain only about 6–7 grams of carbohydrates, which is not enough to effectively manage mild hypoglycemia. A total of 15 grams of fast-acting carbohydrates is needed to raise blood glucose to a safe level. While crackers are useful for long-term blood sugar stabilization, they are not sufficient for initial correction.
C. 120 mL (4 oz) fruit juice: Fruit juice is a fast-acting carbohydrate and is quickly absorbed into the bloodstream, making it effective for treating mild hypoglycemia. Four ounces of juice typically contain approximately 15 grams of carbohydrates, meeting the recommended amount for correcting low blood glucose promptly.
D. Three pieces of hard candy: While hard candy can be used to treat hypoglycemia, three small pieces usually provide only about 9–12 grams of carbohydrates, depending on the brand and size. This may be inadequate to raise blood glucose effectively. The client would likely need 4–5 pieces to meet the 15-gram threshold.

A. Elevate the head of the bed. B. Attach the barrel of the syringe to the tube after removing the plunger. C. Insert air into the tube before pulling back gastric contents. D. Flush the tube with 30 mL water.

Correct Answer is A

Explanation

A. Elevate the head of the bed: Raising the head of the bed to at least 30 to 45 degrees is the first and most essential action to reduce the risk of aspiration during enteral feeding. This position helps ensure that the formula flows into the stomach by gravity and minimizes the potential for reflux of gastric contents into the lungs, which can lead to aspiration pneumonia.
B. Attach the barrel of the syringe to the tube after removing the plunger: This step is necessary for gravity-based enteral feeding when using a syringe. However, it should only be done after confirming tube placement and ensuring the patient is positioned properly. Attaching the syringe before proper safety precautions increases the risk of aspiration.
C. Insert air into the tube before pulling back gastric contents: Injecting air into the gastrostomy tube is part of the verification process to confirm tube placement, often followed by aspirating gastric contents. While this is important, it is not the very first action. The client's head must be elevated first to ensure safety before any manipulation of the tube begins.
D. Flush the tube with 30 mL water: Flushing is necessary to ensure tube patency and to prevent blockage before and after feedings. However, it is not the first step in the procedure. Elevating the head of the bed comes before flushing to prevent aspiration during any subsequent feeding or fluid administration.

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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?

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