After administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.

Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.

Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.

Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.

Choice A reason: A yellow skin color may indicate jaundice, which is a sign of liver damage. Acetaminophen can cause liver toxicity, especially in high doses or with chronic use. The nurse should report this finding to the healthcare provider as soon as possible, as it may require further evaluation and treatment.

Choice B reason: Checking the client's capillary glucose level is not relevant to the finding of yellow skin color. Although diabetes can cause skin changes, such as dryness or infections, it does not cause jaundice. The nurse should focus on the potential liver problem rather than the blood sugar level.

Choice C reason: Using a pulse oximeter to assess oxygen saturation is not helpful in this situation. A low oxygen saturation may indicate hypoxia, which can affect various organs, but it does not cause jaundice. The nurse should monitor the client's respiratory status, but it is not the priority action in response to the yellow skin color.

Choice D reason: Advising the client to reduce the medication dose is not appropriate without consulting the healthcare provider. The client may need acetaminophen for pain relief, and reducing the dose may not be enough to prevent liver damage. The nurse should not make any changes to the medication regimen without the provider's order.