A patient diagnosed with hypoparathyroidism presents to the emergency department with symptoms of tingling around the mouth, muscle spasms, and a prolonged QT interval on the ECG. Which action should the nurse prioritize in the management of this patient?
Administer intravenous calcium gluconate.
Administer magnesium sulfate.
Provide oral calcium supplements.
Schedule a thyroid function test.
The Correct Answer is A
Rationale:
A. The patient is exhibiting acute hypocalcemia with neuromuscular irritability (tingling, muscle spasms, positive Chvostek/Trousseau signs) and cardiac manifestations (prolonged QT interval), which can lead to life-threatening arrhythmias. IV calcium gluconate provides rapid correction of serum calcium, making it the priority intervention in an emergency setting.
B. Magnesium may be needed if hypomagnesemia is present because it can contribute to hypocalcemia, but the immediate life-threatening issue is low calcium, not magnesium deficiency. Administering magnesium alone does not correct the urgent hypocalcemia.
C. Oral calcium is used for long-term management of hypocalcemia in hypoparathyroidism. In an acute, symptomatic emergency with cardiac involvement, oral calcium is too slow to correct the deficit and is not appropriate as the first-line intervention.
D. Thyroid function is not the acute concern in this scenario. While hypoparathyroidism may be related to thyroid or parathyroid surgery, immediate management of symptomatic hypocalcemia is the priority over diagnostic testing.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Rationale:
The client’s symptoms of morning stiffness, symmetrical joint involvement (hands and knees), swelling of proximal interphalangeal joints, and elevated ESR and CRP with a positive rheumatoid factor are characteristic of rheumatoid arthritis. This autoimmune condition causes chronic inflammation of synovial joints, leading to pain, stiffness, and decreased function.
Encouraging range of motion exercises helps maintain joint flexibility, prevent contractures, and improve mobility in clients with rheumatoid arthritis. Administering anti-inflammatory medications reduces joint inflammation, alleviates pain, and slows disease progression.
Monitoring pain level provides insight into the effectiveness of treatment and the client’s functional status. Assessing joint swelling helps evaluate the degree of inflammation and progression or improvement of the disease.
Correct Answer is A
Explanation
Rationale:
A. Hypercalcemia increases the risk of kidney stones, nephrocalcinosis, and cardiac dysrhythmias. Administering IV fluids (usually normal saline) promotes hydration and renal calcium excretion, helping to rapidly lower serum calcium levels and prevent acute complications. This is a priority nursing intervention in the acute management of hypercalcemia.
B. Increasing calcium intake would worsen hypercalcemia and exacerbate complications. Patients with hyperparathyroidism are usually advised to limit excessive calcium intake.
C. While surgical removal of overactive parathyroid tissue is the definitive treatment for primary hyperparathyroidism, it is not an immediate nursing intervention to manage hypercalcemia. Surgery is considered after stabilization and further evaluation.
D. Administering calcium would directly increase serum calcium levels, which is contraindicated in a patient already experiencing hypercalcemia.
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