The nurse is caring for a client with a diagnosis of emphysema of five years. Which of the following findings should the nurse expect to see during the morning assessment? (Select all that apply)

Choice A reason: Dressing involves both sides but can be adapted with the left hand; right-sided CVA impairs left-side function, less affecting dominant right-hand tasks.

Choice B reason: Writing, a fine motor skill, relies on the dominant right hand, controlled by the left brain; right-sided CVA disrupts this, making it most difficult.

Choice C reason: Combing hair uses gross motor skills, manageable with the left hand despite right-sided CVA’s left-sided weakness, less challenging than writing.

Choice D reason: Eating uses the right hand but can be adjusted with utensils or left-hand assistance; it’s less precise than writing, so less impacted.

Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.

Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.

Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.

Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.

Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.