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A nurse is caring for a client with hyperparathyroidism and hypercalcemia. The nurse should expect to administer which of the following priority treatments? SELECT ALL THAT APPLY.

A.

Administer calcium binders

B.

Administer vitamin D supplements

C.

Administer fluids up to 3000 ml/day

D.

Administer Furosemide (Lasix) per orders

E.

Administer oral phosphates

Question Solution

Correct Answer : A,C,D

A. Calcium binders are used to help decrease the amount of calcium absorbed from the gastrointestinal tract, thus lowering calcium levels in the blood.  

 

B. Vitamin D supplements would actually increase calcium levels by enhancing intestinal absorption, so this option is not appropriate in hypercalcemia.  

 

C. Administering fluids helps to dilute serum calcium levels and promote renal excretion of calcium, making it a priority treatment.  

 

D. Furosemide (Lasix) can help promote diuresis, thereby increasing the excretion of calcium through the urine, which is beneficial in managing hypercalcemia.  

 

E. Oral phosphates may be used in some cases to manage hypercalcemia, but they are not a first-line treatment and their administration should be carefully considered in conjunction with other treatments.


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Correct Answer is A

Explanation

A. Chvostek's sign, a facial muscle spasm upon tapping, is a clinical indicator of hypocalcemia, often caused by accidental removal or damage to the parathyroid glands during thyroid surgery.

B. Hypercalcemia does not typically cause a positive Chvostek’s sign.

C. Hypokalemia affects muscle and cardiac function but does not result in a positive Chvostek’s sign.

D. Hyponatremia does not produce Chvostek's sign, which is specific to hypocalcemia.

Correct Answer is B

Explanation

A. Weight gain is not typical in Addison's disease; instead, weight loss is common.

B. Hyperpigmentation, particularly in sun-exposed areas and skin folds, is a classic symptom of Addison's disease due to elevated ACTH levels.

C. Low blood pressure, not elevated, is common due to decreased cortisol levels.

D. Purple striations are more commonly seen in Cushing's syndrome rather than Addison's disease.

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