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.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Fluid restriction doesn’t address hyperkalemia (6.4 mEq/L); it may concentrate potassium further, worsening the condition, as it’s unrelated to potassium excretion or shifting in this scenario.
Choice B reason: Neomycin, an antibiotic, reduces gut bacteria but isn’t used for hyperkalemia. It has no direct effect on potassium levels, making it irrelevant for this lab finding.
Choice C reason: Kayexalate binds potassium in the gut, facilitating its fecal excretion, effectively lowering serum levels (6.4 mEq/L) in hyperkalemia, aligning with urgent correction needs here.
Choice D reason: Sodium chloride and furosemide dilute and excrete potassium via urine, but Kayexalate is preferred for rapid gut-based removal when potassium is critically high (6.4 mEq/L).
Correct Answer is B
Explanation
Choice A reason: Decreased body temperature reflects hypothyroidism; levothyroxine raises metabolism, normalizing or increasing temperature, so this isn’t a therapeutic response.
Choice B reason: Increased energy occurs as levothyroxine restores thyroid hormone, boosting metabolism, reversing hypothyroidism’s fatigue, a key sign of effective treatment.
Choice C reason: Weight gain contradicts levothyroxine’s effect; it increases metabolism, aiding weight loss or stabilization, not gain, in hypothyroidism treatment.
Choice D reason: Decreased appetite isn’t typical; levothyroxine may normalize appetite as metabolism rises, not suppress it, differing from hypothyroidism’s effects.
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