The nurse is teaching a client with Paget's disease about potential complications. What complication should the nurse prioritize?

An elevated alkaline phosphatase (ALP) level is a common finding in patients with Paget's disease. ALP is an enzyme present in bone cells, and its increased activity is indicative of increased bone turnover and remodeling seen in Paget's disease.

a. Serum calcium level: Serum calcium levels may be affected in Paget's disease due to abnormal bone remodeling, but they are not specific enough to confirm the diagnosis on their own.
b. Erythrocyte sedimentation rate (ESR): The ESR is a marker of inflammation and is not specific to Paget's disease. While it may be elevated due to bone inflammation, it does not confirm the diagnosis.
d. Serum creatinine level: Serum creatinine levels are not directly related to the diagnosis of Paget's disease. They are typically assessed to evaluate kidney function.

Administering nonsteroidal anti-inflammatory drugs (NSAIDs) is an essential nursing intervention for managing bone pain in patients with Paget's disease. NSAIDs can help reduce inflammation and alleviate pain associated with bone deformities.

a. Applying cold compresses to the affected area: Applying cold compresses may provide some temporary relief, but it is not the primary intervention for managing bone pain in Paget's disease. NSAIDs are more effective for managing inflammation and pain.

c. Elevating the affected extremity: Elevating the affected extremity is not a specific intervention for managing bone pain in Paget's disease. It may be useful for managing other conditions, such as edema, but not for addressing bone pain.

d. Encouraging bed rest: While rest is important for managing pain, encouraging prolonged bed rest is not advisable for patients with Paget's disease. Moderate physical activity is essential for overall bone health and joint mobility.