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.
Administer calcium binders
Administer vitamin D supplements
Administer fluids up to 3000 ml/day
Administer Furosemide (Lasix) per orders
Administer oral phosphates
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 C
Explanation
A. Diplopia is a concerning symptom but does not indicate immediate deterioration in neurological status like a change in GCS does.
B. Ataxia is also significant but is less acute than a drop in GCS score.
C. A change in the Glasgow Coma Scale score from 13 to 11 indicates a worsening level of consciousness and necessitates immediate reporting, as it may suggest increased intracranial pressure or other complications.
D. A decrease in heart rate from 76 to 69 bpm is not significant enough in the context of TBI to warrant immediate reporting, as it remains within a normal range.
Correct Answer is D
Explanation
A. Exophthalmos is typically associated with hyperthyroidism (specifically Graves' disease) rather than hypothyroidism.
B. Diaphoresis (excessive sweating) is also more common in hyperthyroid states, not hypothyroidism.
C. Palpitations are indicative of an increased metabolic rate, which is common in hyperthyroidism; therefore, they would not be expected in a client with hypothyroidism.
D. Lethargy is a classic symptom of hypothyroidism due to decreased metabolism, leading to fatigue and reduced energy levels, making it the expected finding.