A nurse is caring for a client who has hypoparathyroidism. Which of the following findings should indicate to the nurse that the treatment is effective?

A. Occupational therapist: An occupational therapist helps clients regain skills for daily living, such as dressing and grooming. They are not primarily involved in managing nutritional concerns like decreased weight or prealbumin levels.

B. Physical therapist: A physical therapist focuses on mobility, strength, and balance. While essential in stroke recovery, they are not directly responsible for addressing nutritional issues such as decreased weight or prealbumin.

C. Dietitian: A dietitian is the most appropriate team member for managing the client’s decreased weight and prealbumin. They assess nutritional needs and develop plans to address deficiencies, ensuring the client gets adequate nutrition.

D. Respiratory therapist: A respiratory therapist manages breathing and oxygenation. They are not directly involved in addressing nutritional issues such as weight loss or prealbumin levels.

Rationale for Correct Choices

• Blood glucose: A blood glucose level of 250 mg/dL is critically elevated and puts the client at risk for complications such as delayed wound healing, infection, dehydration, and diabetic ketoacidosis (DKA) if unmanaged. Hyperglycemia impairs immune function and must be addressed promptly to stabilize the client's condition and support healing.
• Wound : The draining, non-healing foot ulcer with purulent discharge indicates infection. However, uncontrolled glucose is a major contributing factor to poor wound healing and increased infection risk. Once glucose levels are addressed, wound care becomes the next critical focus to prevent systemic infection and further tissue damage.

Rationale for Incorrect Choices

• Temperature: While the client has a low-grade fever (38.3°C), which may be related to the infected wound, treating the source of infection and controlling glucose will have a greater and more direct impact on resolving the fever.
• Blood pressure: The blood pressure of 98/74 mm Hg is slightly low but not emergent and does not pose immediate risk. It can be monitored while more pressing concerns—like glucose and wound infection—are managed.
• WBC count: The WBC count of 9,500/mm³ is within normal limits. Although it helps in evaluating infection, it does not require direct intervention and is not a clinical priority compared to glucose control and wound care.