A patient with multiple myeloma develops hypercalcemia. Which intervention can help minimize complications related to hypercalcemia?

Apply heat to painful areas.

Place the patient on bedrest.

Have the patient cough and deep breathe every 2 hours.

Encourage 3 to 4 liters of fluid daily.

Answer and Explanation

The Correct Answer is D

A.   Heat application may provide comfort for localized pain but does not address the underlying cause of hypercalcemia, which requires systemic management.
B.   While rest may be beneficial for certain conditions, it does not directly address hypercalcemia. Encouraging mobility and adequate fluid intake is typically more effective.
C.   Coughing and deep breathing exercises are important for preventing respiratory complications after surgery but are not relevant for managing hypercalcemia.
D.   Increasing fluid intake promotes hydration and enhances urinary calcium excretion, helping to lower serum calcium levels and minimize complications associated with hypercalcemia

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Correct Answer is C

Explanation

A. This meal is high in fat, which may be poorly tolerated after a cholecystectomy, as it can exacerbate symptoms such as diarrhea and abdominal discomfort.
B. This meal is high in fat and may be difficult to digest after a cholecystectomy.

Whole milk can also be rich in fat, which may not be well tolerated.

C. This meal is lower in fat and includes easily digestible foods such as roast turkey and rice, which are generally well tolerated after a cholecystectomy. Gelatin dessert provides a light and refreshing option for dessert without adding excess fat.
D. This meal is high in fat, which may be poorly tolerated after a cholecystectomy, as it can exacerbate symptoms such as diarrhea and abdominal discomfort.

A. 80-year-old male patient with a history of atrial fibrillation with rapid ventricular response whose cardiac monitor shows a heart rate of 92 B. 66-year-old female patient with a newly inserted permanent pacemaker whose cardiac monitor shows a heart rate of 50 C. 72-year-old male patient with an implantable cardiac defibrillator that delivered a shock 4 hours ago whose cardiac monitor shows normal sinus rhythm and a heart rate of 68 D. 78-year-old male patient with chronic atrial fibrillation who is prescribed metoprolol (Toprol) whose cardiac monitor shows a heart rate of 58.

Correct Answer is B

Explanation

A. While atrial fibrillation with a rapid ventricular response requires attention, it is not an immediate concern unless associated with symptoms such as chest pain, shortness of breath, or hemodynamic instability.
B. A heart rate of 50 in a patient with a newly inserted permanent pacemaker may indicate bradycardia, which could be a sign of pacemaker malfunction or lead dislodgement. This patient requires immediate assessment to rule out complications.
C. While recent implantable cardioverter-defibrillator (ICD) discharge warrants evaluation, the patient is currently in normal sinus rhythm with a heart rate of 68, suggesting stability. This patient's assessment can be prioritized after the patient with the pacemaker issue is seen.
D. A heart rate of 58 in a patient with chronic atrial fibrillation on beta-blocker therapy may not be immediately concerning if the patient is asymptomatic and hemodynamically stable. This patient can be assessed after addressing the more urgent pacemaker issue.

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A patient with multiple myeloma develops hypercalcemia. Which intervention can help minimize complications related to hypercalcemia?

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