A patient with angina has been given 0.4 mg of nitroglycerin SL and reports continued chest pain 5 minutes later.
The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. What action should the nurse take next?

Choice A rationale:

Calcitonin (Fortical) is a hormone that lowers blood calcium levels. It is not indicated for the treatment of hypocalcemia caused by parathyroid hormone deficiency. In fact, it could worsen the condition by further reducing calcium levels.

Calcitonin is primarily used to treat hypercalcemia (high calcium levels) and osteoporosis.

It works by inhibiting osteoclast activity, which reduces bone resorption and calcium release into the bloodstream.

Choice B rationale:

Calcium is the essential mineral for treating hypocalcemia. It directly replenishes calcium levels in the blood.

Calcium can be administered orally (PO) or intravenously (IVPB), depending on the severity of the hypocalcemia and the patient's condition.

Oral calcium is often preferred for mild to moderate hypocalcemia, while IV calcium is typically used for severe hypocalcemia or when rapid correction is necessary.

Calcium supplements are available in various forms, including calcium carbonate, calcium citrate, and calcium gluconate. The dosage of calcium will be individualized based on the patient's serum calcium levels and clinical response.

Choice C rationale:

Vitamin B12 is not directly involved in calcium regulation. It is essential for red blood cell production and nerve function. While vitamin B12 deficiency can sometimes be associated with hypocalcemia, it is not a primary treatment for this condition. Choice D rationale:

Vitamin D3 (Calcitriol) is a hormone that aids in calcium absorption from the intestines. It is often used in conjunction with calcium supplements to treat hypocalcemia.

However, vitamin D3 alone is not sufficient to treat hypocalcemia caused by parathyroid hormone deficiency. Parathyroid hormone is essential for activating vitamin D3 in the kidneys, so its deficiency limits the effectiveness of vitamin D3.

Choice A rationale:

Insulin is a protein-based hormone that is sensitive to heat and light. Exposure to high temperatures or direct sunlight can cause insulin to break down and become less effective.

Refrigeration helps to maintain the stability and potency of insulin. It is generally recommended to store unopened insulin vials in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C).

This temperature range helps to slow down the degradation process and ensure that the insulin remains effective until its expiration date.

Choice B rationale:

Insulin should never be frozen. Freezing can cause the insulin to crystallize and become unusable. Once insulin has been frozen, it cannot be thawed and used again.

Choice C rationale:

Opened vials of insulin do not need to be discarded immediately. They can be stored in the refrigerator for up to 28 days, depending on the type of insulin.

However, it is important to note the date that the vial was opened and to discard it after the recommended storage period.

Choice D rationale:

Insulin pens should be stored according to the manufacturer’s instructions. Some insulin pens can be stored at room temperature for a certain period of time, while others must be refrigerated.

It is important to read the instructions that come with the insulin pen to ensure that it is stored properly.