An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?

Calcitonin is a medication used to treat postmenopausal osteoporosis in older adults. It works by inhibiting bone resorption and decreasing the breakdown of bone tissue. Calcitonin is available in several forms, including intranasal spray, subcutaneous injection, and intravenous infusion. However, for the treatment of postmenopausal osteoporosis, calcitonin is most commonly administered via intranasal spray.

Intranasal calcitonin is easy to use and well-tolerated by most clients. It is absorbed through the nasal mucosa and reaches peak blood levels within 30-60 minutes after administration. The medication is usually administered once daily, alternating nostrils with each dose.

Other routes of administration, such as subcutaneous injection and intravenous infusion, may be used in certain situations, such as for the treatment of Paget's disease of bone or hypercalcemia. However, these routes of administration are less commonly used for the treatment of postmenopausal osteoporosis in older adults. The healthcare provider will determine the appropriate route of administration based on the individual client's needs and medical history.

Hydrocortisone is a synthetic form of the hormone cortisol, which is produced by the adrenal glands. Addison's disease is a condition in which the adrenal glands do not produce enough cortisol and other hormones. Treatment with hydrocortisone is a lifelong therapy that replaces the missing hormones.

One of the potential adverse effects of long-term treatment with hydrocortisone is the development of sodium depletion or hyponatremia. This occurs because hydrocortisone can increase the excretion of sodium in the urine, leading to low levels of sodium in the blood.

To mitigate this potential adverse effect, the nurse should encourage the client to increase their intake of sodium. This can be done through dietary sources such as adding more salt to their food or drinking sports drinks that contain electrolytes. The client should also be monitored closely for signs of sodium depletion, such as weakness, fatigue, and confusion.

It is also important to note that long-term treatment with hydrocortisone can increase the risk of other adverse effects, such as osteoporosis, hyperglycemia, and infection. The nurse should educate the client on these potential adverse effects and encourage them to follow their healthcare provider's instructions for monitoring and management.