After administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

Choice A reason: Muscle tenderness is a sign of myopathy, a rare but serious adverse effect of atorvastatin and other statins. Myopathy is characterized by muscle weakness, pain, and elevated CK levels. CK is an enzyme that is released when muscle tissue is damaged. The nurse should monitor the client for muscle tenderness and report any changes to the prescriber.

Choice B reason: Nausea and vomiting are common side effects of atorvastatin, but they are not related to CK levels. The nurse should advise the client to take the medication with food and fluids to minimize gastrointestinal discomfort.

Choice C reason: Excessive bruising is not a typical side effect of atorvastatin, nor is it associated with CK levels. The nurse should assess the client for other possible causes of bleeding, such as coagulation disorders, trauma, or drug interactions.

Choice D reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to CK levels. The nurse should assess the client for other signs of fluid retention, such as weight gain, shortness of breath, or jugular venous distension. The nurse should also check the client's blood pressure and heart rate, as peripheral edema may indicate heart failure or hypertension.

Choice A reason: Diabetic ketoacidosis is a complication of diabetes that occurs when the body produces high levels of ketones due to lack of insulin. Glucagon is not indicated for this condition, as it would increase the blood glucose level even more. The nurse should instruct the client and family to monitor the blood glucose and ketone levels, administer insulin as prescribed, and seek medical attention if the condition worsens.

Choice B reason: Glucagon is not used to prevent hyperglycemia, which is a high blood glucose level. Glucagon is a hormone that raises the blood glucose level by stimulating the breakdown of glycogen in the liver. The nurse should instruct the client and family to prevent hyperglycemia by following a balanced diet, taking insulin as prescribed, and exercising regularly.

Choice C reason: Glucagon is not used when the client is unable to eat during sick days, unless the client has signs of hypoglycemia, which is a low blood glucose level. Glucagon is used as a last resort when the client is unconscious or unable to swallow. The nurse should instruct the client and family to follow the sick day rules, which include monitoring the blood glucose and urine ketone levels, taking insulin as prescribed, drinking fluids, and eating small amounts of carbohydrates.

Choice D reason: Glucagon is used when the client has signs of severe hypoglycemia, such as confusion, seizures, or loss of consciousness. Glucagon is injected subcutaneously or intramuscularly by a family member or a caregiver to raise the blood glucose level quickly. The nurse should instruct the client and family to recognize the signs of hypoglycemia, treat mild to moderate hypoglycemia with oral glucose, and call 911 after administering glucagon.