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The nurse is reviewing the laboratory results of a client who reports taking five times the recommended daily allowance of vitamins and minerals in a multivitamin form. Which finding indicates a possible vitamin D overdose?

Reference Range:

  • Bilirubin [0.3 to 1 mg/dL (5.1 to 17 μmol/L)]
  • Calcium 19 to 10.5 mg/dL (2.3 to 2.6 mmol/L)]
  • Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]
  • Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

A.

Sodium level 140 mEq/L (140 mmol/L).

B.

Total calcium level 12 mEq/L (3 mmol/L).

C.

Total bilirubin 4 mg/dL (68.4 μmol/L).

D.

Serum glucose 170 mg/dL (9.4 mmol/L).

Answer and Explanation

The Correct Answer is B

A) Sodium level 140 mEq/L (140 mmol/L):
The sodium level within the reference range does not indicate a vitamin D overdose. Sodium levels are typically not affected by vitamin D overdose.

B) Total calcium level 12 mg/dL (3 mmol/L):
This finding suggests a possible vitamin D overdose. Vitamin D plays a crucial role in calcium absorption from the intestines. Excessive vitamin D intake can lead to increased calcium absorption, resulting in hypercalcemia. Elevated calcium levels can lead to various symptoms such as nausea, vomiting, weakness, and confusion. Monitoring calcium levels is essential in individuals with suspected vitamin D overdose.

C) Total bilirubin 4 mg/dL (68.4 μmol/L):
Elevated bilirubin levels typically indicate liver dysfunction or hemolysis. It is not directly related to vitamin D overdose.

D) Serum glucose 170 mg/dL (9.4 mmol/L):
Elevated glucose levels suggest hyperglycemia, which can occur due to various factors such as diabetes mellitus or stress response. It is not directly related to vitamin D overdose.
 


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Related Questions

Correct Answer is ["200"]

Explanation

The nurse should program the infusion pump to deliver 200 mL/hr.

Although the medication dosage is 400 mg, the infusion pump rate is determined by the total volume of the IV fluid (including the medication) and the desired infusion time.

In this case:

Total volume of IV bag (D,W): 200 mL

Infusion time: 1 hour

Since the medication is already diluted in the 200 mL bag, the entire volume needs to be delivered over the course of the hour. Therefore, the nurse should program the pump to deliver the full 200 mL of the solution at a rate of:

200 mL / 1 hour = 200 mL/hr

Correct Answer is B

Explanation

A) Stop the oral contraceptive immediately:
This instruction is incorrect and potentially dangerous. Abruptly stopping oral contraceptives can lead to unintended pregnancy and disrupt the client's menstrual cycle. It's essential for the client to continue taking their oral contraceptive unless instructed otherwise by their healthcare provider.

B) Use an additional form of contraception:
This is the correct action. Erythromycin is an antibiotic that can reduce the effectiveness of oral contraceptives by altering the gut flora and potentially interfering with their absorption. Therefore, it is recommended to use an additional form of contraception, such as condoms, while taking erythromycin to prevent unintended pregnancy.

C) Take the medications at least 12 hours apart:
While it's generally a good practice to space medications apart to avoid interactions, specific instructions regarding the timing of erythromycin and oral contraceptive administration should be obtained from the healthcare provider. Simply spacing the medications apart may not be sufficient to prevent contraceptive failure.

D) Avoid prolonged exposure to direct sunlight:
This instruction is unrelated to the interaction between erythromycin and oral contraceptives. Erythromycin can increase sensitivity to sunlight (photosensitivity), but this does not affect the effectiveness of oral contraceptives. Therefore, while it's important to advise clients to protect themselves from sun exposure while taking erythromycin, it's not directly related to contraceptive use.

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