The nurse is caring for a client with hyperparathyroidism. Which of the following orders from the healthcare provider can be expected to reduce the client's overproduction of calcium? (Select all that apply)
Calcium carbonate PO three times a day
Low calcium, high fiber diet
Parathyroidectomy
Furosemide PO daily
Fluid restriction
Correct Answer : B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Lactulose doesn’t lower glucose; it’s a sugar metabolized by gut bacteria, unrelated to blood sugar control in cirrhosis, where glucose issues stem elsewhere.
Choice B reason: In cirrhosis, lactulose traps ammonia in the gut by acidifying it, promoting excretion and reducing toxic levels that cause hepatic encephalopathy, the primary goal.
Choice C reason: Potassium levels aren’t directly reduced by lactulose; it affects ammonia via gut pH, not electrolytes like potassium, which may rise in renal issues.
Choice D reason: Bicarbonate isn’t targeted by lactulose; it’s a buffer altered in acid-base imbalances, not the focus in cirrhosis where ammonia reduction is critical.
Correct Answer is C
Explanation
Choice A reason: Radioactive iodine treats hyperthyroidism by destroying thyroid tissue, reducing hormone production. It’s contraindicated in hypothyroidism, where hormone replacement is needed instead.
Choice B reason: Sumatriptan, a serotonin agonist, treats migraines by constricting blood vessels. It has no role in hypothyroidism, which requires thyroid hormone supplementation.
Choice C reason: Levothyroxine replaces deficient thyroid hormone in hypothyroidism, normalizing metabolism by mimicking T4, addressing symptoms like fatigue and weight gain effectively.
Choice D reason: Levofloxacin, an antibiotic, fights bacterial infections but doesn’t address hypothyroidism’s hormonal deficiency, making it irrelevant to this condition’s treatment.
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