When providing client teaching to the family of a 12-year-old child receiving somatropin, the nurse stresses the need to notify prescriber if what manifestation occurs?

Hypercalcemia is a condition caused by having too much calcium in the blood, which can affect the function of nerves, muscles, kidneys and heart. Hypercalcemia can occur in children due to various causes, both acquired and genetic. One of the most common causes of hypercalcemia in children is cancer, especially cancers that affect the bones or produce substances that mimic parathyroid hormone (PTH), which regulates calcium levels.

Choice A is wrong because liver failure does not directly cause hypercalcemia, although it can affect vitamin D metabolism and calcium absorption.

Choice B is wrong because radiation injury does not cause hypercalcemia, unless it damages the parathyroid glands or causes bone destruction.

Choice D is wrong because hypothyroidism does not cause hypercalcemia, although it can affect bone turnover and calcium excretion.

A. A 12-year-old child with obsessive-compulsive disorder is not typically a candidate for misoprostol, as it is not indicated for this condition.

B. A 46-year-old trial lawyer with hypertension might need caution when using misoprostol, as it can cause diarrhea and abdominal pain, which could be problematic.

C. An 83-year-old client with rheumatoid arthritis is the best candidate for misoprostol, particularly if they are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for their condition. Misoprostol is often used to prevent NSAID-induced gastric ulcers in patients at high risk, such as elderly individuals or those with a history of ulcers.

D. A 22-year-old pregnant client should not be given misoprostol unless it is used for specific obstetric indications under close supervision. Misoprostol can induce uterine contractions and is contraindicated in pregnancy unless used for medical reasons like inducing labor or treating postpartum hemorrhage.