Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dl (1.4 mmol/L). Which action is most important for the nurse to take?
Reference Range:
Total Calcium 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)
A. Notify the healthcare provider immediately
B.Administer a calcium supplement as ordered by the healthcare provider
C. Administer the medication with a glass of milk.
D. Begin tapering the drug dose per protocol.
Notify the healthcare provider immediately
Administer a calcium supplement as ordered by the healthcare provider
Administer the medication with a glass of milk.
Begin tapering the drug dose per protocol.
The Correct Answer is A
A) A total calcium level of 5.5 mg/dL (1.4 mmol/L) is critically low, as the normal reference range for total calcium is between 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L). Hypocalcemia can lead to serious complications such as tetany, arrhythmias, and seizures. Before administering methylprednisolone, which can further decrease calcium levels and contribute to osteoporosis, it is essential to notify the healthcare provider to address the client's low calcium level. This may involve correcting the calcium deficiency before proceeding with the administration of the
B) If a healthcare provider orders a calcium supplement for the client, administering it would be appropriate to help correct the hypocalcemia before administering methylprednisolone. However, in the absence of a direct order, the nurse should first notify the healthcare provider to ensure that the client's calcium levels are addressed appropriately before proceeding with any medication that could exacerbate the issue. The priority is to manage the low calcium levels before administering corticosteroids like methylprednisolone.
C) Administering methylprednisolone with a glass of milk may help with calcium absorption; however, this does not directly address the critical issue of hypocalcemia. The nurse must first prioritize notifying the healthcare provider and correcting the calcium imbalance before proceeding with medication administration.
D) Tapering the dose of methylprednisolone is not immediately appropriate based on the low calcium level alone. Methylprednisolone is often tapered to avoid withdrawal symptoms, but the nurse's first priority is to address the client's hypocalcemia, which can have more immediate clinical consequences. The focus should be on stabilizing the calcium level first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Be aware that difficulty sleeping and weight loss may occur: This is the correct answer. Bupropion is associated with potential side effects such as insomnia and weight loss. It is essential for the nurse to inform the client about these possible adverse effects to ensure they are aware and can monitor for them. By being informed, the client can report any concerns promptly to their healthcare provider.
B) Administer each dose with at least 8 ounces (240 ml) of water: While it is generally advisable to take medications with a full glass of water, this instruction is not specifically related to bupropion. Therefore, it is not the most pertinent information for discharge teaching regarding this medication.
C) Consume tyramine-free foods while taking the medicine: This instruction is not relevant to bupropion. Tyramine restriction is typically associated with monoamine oxidase inhibitors (MAOIs), not bupropion.
D) Notify the healthcare provider if experiencing changes in taste: Changes in taste are not commonly associated with bupropion use. While it is important to monitor for and report any unusual symptoms while taking medication, difficulty sleeping and weight loss are more commonly observed adverse effects of bupropion that should be emphasized in discharge teaching for a client prescribed this medication to reduce nicotine cravings.
Correct Answer is C
Explanation
A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.
B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.
C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.
D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.
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