The nurse is caring for a patient with hyperparathyroidism.
Upon assessment, the nurse notes polyuria, polydipsia, nausea, and vomiting and the following lab values: Potassium: 130 mg/dL. Calcium: 4.7 mg/dL. Phosphorus: 13.1 mg/dL. Magnesium: 25 mg/dL. Which of the following medications is recommended for this patient?

Choice A rationale

Neutropenic precautions and broad-spectrum antibiotics are indicated for patients with neutropenia to prevent infections. However, the patient's ANC is within the normal range (2400/mm³), so these measures are not necessary. This choice does not address the low hemoglobin and platelet count.

Choice B rationale

Contact isolation precautions and intravenous prednisone are not relevant to the patient's current condition. Prednisone is an immunosuppressive corticosteroid used for inflammatory and autoimmune conditions, but it does not address the patient's anemia or thrombocytopenia.

Choice C rationale

Bleeding precautions and platelet transfusion are appropriate interventions for the patient. The platelet count is critically low (6,000/mm³), putting the patient at high risk for spontaneous bleeding. Platelet transfusion is needed to increase platelet levels and reduce bleeding risk. Bleeding precautions, such as avoiding invasive procedures and using gentle oral care, help minimize the risk of hemorrhage.

Choice D rationale

Bedrest and packed red blood cell transfusion address the patient's anemia (hemoglobin 8.4 g/dL, hematocrit 25.9%). While these interventions are necessary to improve oxygen-carrying capacity, they do not address the critical issue of thrombocytopenia. Combining interventions C and D would be ideal for comprehensive care, but based on the question, Choice C is most critical for immediate bleeding risk management. .

Choice A rationale

Pain from mucositis and oral tissue injury is a significant concern for patients undergoing chemotherapy. However, it is not typically life-threatening and can be managed with appropriate pain relief measures and oral care.

Choice B rationale

Weakness and fatigue with activity are common side effects of chemotherapy and the disease process itself. While these symptoms impact the patient's quality of life, they do not usually require urgent intervention.

Choice C rationale

Blood pressure of 90/64 mmHg, pulse of 102 beats per minute, and oral temperature of 38.5 degrees Celsius suggest possible sepsis or severe infection. These vital signs indicate an urgent need for intervention to prevent further deterioration and potentially life-threatening complications.

Choice D rationale

Scattered ecchymosis and petechiae are signs of thrombocytopenia (low platelet count), which is a common complication of leukemia and its treatment. While important to monitor and manage, these findings are not typically as urgent as signs of sepsis or severe infection.