A nurse is teaching a patient who has a new diagnosis of hyperparathyroidism.
The nurse should include in the teaching that the patient is at risk for which of the following complications?

Choice A rationale
While it is true that an increased weight in the abdomen can lead to discomfort when lying down, simply having extra pillows in bed may not be sufficient to address the issue. Ascites, or the accumulation of fluid in the peritoneal cavity, can cause significant discomfort and even

pain. It can also lead to respiratory issues as the fluid puts pressure on the diaphragm, making breathing difficult. Therefore, while extra pillows may help to some extent by allowing the patient to find a more comfortable position, they are not a comprehensive solution.
Choice B rationale
Advising the patient not to wear undergarments because they will not fit due to the increased weight in the abdomen is not a medically sound advice. While it is true that ascites can cause distension of the abdomen, the focus should be on treating the underlying condition and managing the symptoms, rather than on the fit of the patient’s clothing. Moreover, the choice of clothing is a personal decision and may have psychological implications for the patient.
Choice C rationale
The statement that the increased weight in the abdomen means that the patient can no longer exercise due to the strain on the heart is not entirely accurate. While it is true that ascites can put additional strain on the heart and other organs, it does not necessarily mean that all forms of exercise are contraindicated. In fact, gentle forms of exercise may be beneficial for overall health and well-being. However, any exercise regimen should be discussed with and approved by a healthcare provider.
Choice D rationale
This is the correct choice. Due to the increased abdominal weight from ascites, the patient’s balance might indeed be affected, increasing the risk of falls. Therefore, advising the patient to take their time with walking is a valid precaution. Fall prevention is a key aspect of care for patients with ascites due to end-stage liver disease.

Choice A rationale
While liver issues can be a concern with certain medications or diseases, they are not typically associated with GERD. GERD is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. Therefore, monitoring for liver issues would not be directly relevant to a patient with GERD.
Choice B rationale
Pancreatic cancer is a serious condition, but it is not directly related to GERD. GERD is primarily an issue of the esophagus and stomach, not the pancreas. While it’s always important to be vigilant about potential health issues, there is no specific reason for a patient with GERD to watch for manifestations of pancreatic cancer.
Choice C rationale
While diabetes is a significant health concern, it is not directly linked to GERD. GERD does not increase the risk for diabetes. An endocrinologist specializes in hormonal disorders, including

diabetes, but would not typically be involved in the management of GERD unless there were other co-existing endocrine issues.
Choice D rationale
This is the correct answer. Barrett’s esophagus is a condition that can develop in people who have long-term GERD. It changes the color and composition of the esophagus lining, which can increase the risk of esophageal cancer. Therefore, it is important for patients with long-term GERD symptoms to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.