When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Choice A reason:

Teaching the client about foods high in calcium is important, but it is not the most immediate action required. A serum calcium level of 5.5 mg/dL is significantly below the normal range (8.5-10.2 mg/dL) and indicates severe hypocalcemia. While dietary education is beneficial for long-term management, the nurse must first address the acute issue by notifying the healthcare provider.

Choice B reason:

Beginning to taper the drug dose per protocol is not appropriate without consulting the healthcare provider. Methylprednisolone, a corticosteroid, can cause decreased calcium absorption and increased calcium excretion. However, any changes to the medication regimen should be directed by the healthcare provider, especially in the context of severe hypocalcemia.

Choice C reason:

Notifying the healthcare provider of the finding is the most critical action. Severe hypocalcemia can lead to serious complications such as cardiac arrhythmias, muscle spasms, and seizures. Immediate medical intervention is necessary to correct the calcium imbalance and prevent potential life-threatening conditions.

Choice D reason:

Administering the medication with a glass of milk is not sufficient to address the severe hypocalcemia. While milk contains calcium, the amount is not enough to correct a serum calcium level as low as 5.5 mg/dL. The nurse must prioritize notifying the healthcare provider to ensure appropriate treatment is initiated.

Word count: 500 words.

Choice A reason: Denying having coughing spells indicates that the antitussive medication benzonatate is effective. Benzonatate works by numbing the throat and lungs, reducing the cough reflex. This means that if the client is no longer experiencing coughing spells, the medication is performing its intended function.

Choice B reason: Being able to sleep through the night can be an indirect indicator of the medication’s effectiveness, but it is not as specific as denying coughing spells. While improved sleep might result from reduced coughing, it could also be influenced by other factors such as overall improvement in the client’s condition or the use of other medications.

Choice C reason: Expectorating bronchial secretions is not a direct indicator of the effectiveness of benzonatate. Benzonatate is an antitussive, meaning it suppresses the cough reflex rather than promoting the expulsion of mucus. Therefore, expectorating bronchial secretions would not be a primary measure of this medication’s effectiveness.

Choice D reason: Reporting reduced nasal discharge is also not a direct indicator of the effectiveness of benzonatate. This medication specifically targets the cough reflex and does not have a significant impact on nasal discharge. Reduced nasal discharge could be due to other factors or treatments.