A nurse is collecting data from a client who has hypercalcemia. Which of the following findings should the nurse expect?

A. Blood pressure: A reading of 90/50 mm Hg indicates hypotension, suggesting possible acute blood loss or hypovolemia. In the context of suspected gastrointestinal bleeding, this finding raises concern for compromised perfusion. Immediate evaluation and intervention are required to prevent progression to shock.

B. WBC count: A WBC count of 6,700/mm³ falls within the normal reference range and does not indicate acute infection or inflammatory response. It does not contribute to the immediate hemodynamic or bleeding concerns evident in this client.

C. Respiratory rate: A respiratory rate of 18/min is within normal limits for an adult. There is no evidence of respiratory compensation for metabolic acidosis or hypoxia at this time. This finding does not require urgent follow-up.

D. Hemoglobin and hematocrit: Markedly reduced hemoglobin and hematocrit indicate significant anemia, likely secondary to gastrointestinal blood loss. These values correlate with the client’s pallor, tachycardia, and hypotension. Prompt evaluation is needed to assess bleeding severity and need for transfusion.

E. Temperature: A temperature of 37.5°C represents a low-grade elevation but does not indicate acute infection or sepsis. It is not the primary concern compared with signs of active bleeding and hemodynamic instability.

F. Stool results: A positive hemoccult test confirms gastrointestinal bleeding, consistent with melena and anemia. This finding supports an upper GI source, such as a bleeding peptic ulcer. Immediate follow-up is needed to localize and control the bleed.

G. Current medications: Regular use of high-dose ibuprofen increases the risk of gastric mucosal injury and peptic ulcer disease. NSAIDs inhibit prostaglandin synthesis, impairing gastric protection and promoting bleeding. This medication likely contributes to the current condition and requires urgent reassessment.

H. Heart rate: A heart rate of 118/min reflects tachycardia, commonly seen as a compensatory response to hypovolemia or acute blood loss. This finding aligns with hypotension and anemia, indicating cardiovascular strain. Prompt intervention is necessary to stabilize the client.

A. "You should stop taking your antituberculin medication after 2 weeks.": Antitubercular medications must be taken for the full prescribed course, often 6–9 months, to ensure eradication of Mycobacterium tuberculosis and prevent drug resistance. Stopping early can lead to treatment failure and multidrug-resistant TB.

B. "You should have a sputum examination every 4 weeks.": Regular sputum testing allows monitoring of treatment effectiveness and confirms when the client is no longer infectious. Monthly sputum cultures are standard practice during TB therapy to guide clinical management.

C. "You should obtain a chest x-ray every 3 months.": Chest x-rays may be repeated to assess healing in complicated cases, but they are not required routinely every 3 months for all clients during treatment. Sputum testing is more reliable for evaluating infectious status.

D. "You should schedule a tuberculin skin test every 6 months.": Tuberculin skin tests are used for initial diagnosis or exposure screening, not for monitoring treatment response in clients with active TB. Repeating the test during therapy does not provide useful clinical information.