A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L). and high urine calcium. While the patient awaits surgery, the nurse should:
institute seizure precautions such as padded side rails.
assist the patient to perform range-of-motion exercises QID.
encourage the patient to drink 4000 ml of fluid daily.
monitor the patient for positive Chvostek’s or Trousseaus sign.
The Correct Answer is C
The patient with primary hyperparathyroidism has high levels of calcium in the blood (hypercalcemia) which can lead to symptoms such as kidney stones, bone pain, and weakness. High urine calcium levels may also be present due to the increased calcium in the blood.
One important intervention for managing hypercalcemia is to encourage fluid intake to promote increased urine output and prevent the formation of kidney stones. Therefore, the nurse should encourage the patient to drink at least 4000 ml of fluids per day.
Seizure precautions (a), range-of-motion exercises (b), and monitoring for positive Chvostek’s or Trousseaus sign (d) are not directly related to managing hypercalcemia and are not necessary in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
acromegaly typically causes an enlargement of the hands and feet. The nurse can inquire if the patient has noticed any changes in shoe size, as this may indicate abnormal growth.
"Are you experiencing tremors or anxiety" is not directly related to acromegaly, and although anxiety can be associated with some medical conditions, it is not a typical symptom of acromegaly.
"Is there any family history of acromegaly?" is also a relevant question, as acromegaly can be caused by a genetic disorder. If the patient has a family history of the condition, this may increase their risk of developing it.
"Have you had a recent head injury?" is not specifically related to acromegaly, although head trauma can cause a variety of medical conditions.
Overall, option a. is the most relevant question to ask a patient with suspected acromegaly.
Correct Answer is C
Explanation
Before administering any medication, the nurse should confirm the potassium level to ensure that it is still elevated and needs to be treated. Potassium levels can fluctuate, so repeating the test will ensure that the client receives the appropriate treatment.
Options (a) Withhold the medication and (b) Administering a hypertonic solution may be appropriate interventions depending on the client's condition, but confirming the potassium level is the first step.
Option (d) Monitoring for paresthesia is important but not the first action that the nurse should take.
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