A nurse in public clinic is planning a health fair for older adult clients in the community. In teaching medication safety, which of the following foods should the nurse advise the clients to avoid when taking their prescriptions?

A) Notify the facility’s ethics committee:
While it may be relevant to involve an ethics committee in certain complex situations, such as when there are concerns about patient autonomy or ethical decision-making, the refusal of a medication by a client is generally a standard issue that does not immediately require ethics consultation.

B) Return the opened medication in the medication cart:
Returning an opened unit-dose medication to the cart is not appropriate. Once a unit-dose medication is opened, it cannot be reused due to safety concerns (e.g., contamination, dosage errors). The opened medication should be disposed of properly according to the facility's policies for medication handling and disposal.

C) Report the incident to the provider:
The provider should be notified when a client refuses medication, especially if the medication is essential for the client’s treatment or health condition. It is important for the nurse to document the refusal and inform the provider so that appropriate follow-up can be arranged, including possible reassessment of the treatment plan, alternative medications, or further education for the client.

D) Fill out an incident report:
An incident report is typically completed for situations that involve safety issues, errors, or accidents that may affect patient safety or quality of care. While refusal of medication is an important event, it does not generally require an incident report unless it involves an unusual or dangerous situation, such as a medication error or patient harm.

A) Chloride 112:
Chloride levels are typically not directly associated with numbness or tingling of the hands and fingers. Elevated chloride levels (greater than 108 mEq/L) may indicate metabolic acidosis, but they would not directly explain the symptoms seen in this client following parathyroidectomy. Therefore, this value is unlikely to be relevant in this scenario.

B) Calcium 7.5:
After the partial removal of the parathyroid glands, the client may experience hypocalcemia, or low calcium levels, due to the reduced production of parathyroid hormone (PTH). PTH helps regulate calcium levels in the blood. When the parathyroid glands are removed or damaged, there may be insufficient PTH to maintain normal calcium levels, leading to hypocalcemia. Symptoms of hypocalcemia include numbness and tingling, especially in the hands and fingers. A calcium level of 7.5 mg/dL is below the normal range (8.5–10.5 mg/dL), indicating hypocalcemia, which is consistent with the patient's symptoms.

C) Potassium 4.0:
A potassium level of 4.0 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not typically cause numbness or tingling. Although potassium imbalances can cause neuromuscular symptoms, they would not be the most likely cause of the symptoms in this case, especially in relation to parathyroidectomy.

D) Calcium 12.1:
A calcium level of 12.1 mg/dL is elevated and would suggest hypercalcemia. Hypercalcemia can cause symptoms like fatigue, confusion, and weakness, but it does not typically cause numbness and tingling in the hands and fingers. Elevated calcium levels are more likely to occur in conditions such as hyperparathyroidism or malignancy, not typically following parathyroid gland removal. Therefore, this is not the expected lab result in this scenario.