Prior to administering an oral dose of methylprednisolone, the nurse determines the client's serum total calcium level is 5.5 mg/dl (1.4 mmol/L). Which action is most important for the nurse to take?

Reference Range:

Total Calcium 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L)
A. Notify the healthcare provider immediately

B.Administer a calcium supplement as ordered by the healthcare provider

C. Administer the medication with a glass of milk.

D. Begin tapering the drug dose per protocol.

Notify the healthcare provider immediately

Administer a calcium supplement as ordered by the healthcare provider

Administer the medication with a glass of milk.

Begin tapering the drug dose per protocol.

Answer and Explanation

The Correct Answer is A

A) A total calcium level of 5.5 mg/dL (1.4 mmol/L) is critically low, as the normal reference range for total calcium is between 9 to 10.4 mg/dL (2.3 to 2.6 mmol/L). Hypocalcemia can lead to serious complications such as tetany, arrhythmias, and seizures. Before administering methylprednisolone, which can further decrease calcium levels and contribute to osteoporosis, it is essential to notify the healthcare provider to address the client's low calcium level. This may involve correcting the calcium deficiency before proceeding with the administration of the

B) If a healthcare provider orders a calcium supplement for the client, administering it would be appropriate to help correct the hypocalcemia before administering methylprednisolone. However, in the absence of a direct order, the nurse should first notify the healthcare provider to ensure that the client's calcium levels are addressed appropriately before proceeding with any medication that could exacerbate the issue. The priority is to manage the low calcium levels before administering corticosteroids like methylprednisolone.

C) Administering methylprednisolone with a glass of milk may help with calcium absorption; however, this does not directly address the critical issue of hypocalcemia. The nurse must first prioritize notifying the healthcare provider and correcting the calcium imbalance before proceeding with medication administration.

D) Tapering the dose of methylprednisolone is not immediately appropriate based on the low calcium level alone. Methylprednisolone is often tapered to avoid withdrawal symptoms, but the nurse's first priority is to address the client's hypocalcemia, which can have more immediate clinical consequences. The focus should be on stabilizing the calcium level first.

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Correct Answer is B

Explanation

A) A serum creatinine level of 1.0 mg/dL falls within the reference range (0.5 to 1.1 mg/dL) and does not indicate immediate action by the nurse. Creatinine levels within the reference range suggest normal kidney function.

B) A platelet count of 100,000/mm3 (100 x 10^9/L) is below the lower limit of the reference range (150,000 to 400,000/mm3). Thrombocytopenia, or low platelet count, increases the risk of bleeding complications, especially when administering anticoagulants like enoxaparin. Therefore, a platelet count of 100,000/mm3 requires immediate action by the nurse to assess for bleeding and notify the healthcare provider.

C) A hematocrit of 45% (0.45 volume fraction) falls within the reference range (42% to 52%) and does not indicate immediate action by the nurse.

D) A blood urea nitrogen (BUN) level of 20 mg/dL (7.1 mmol/L) falls within the reference range (10 to 20 mg/dl) and does not indicate immediate action by the nurse.

A. Report any tendon pain or swelling to the healthcare provider immediately. B. Limit exposure to sunlight and avoid tanning beds. C. Crush and mix the tablets with pudding if you have trouble swallowing the tablets. D. Increase fluid intake while taking the medication. E. Use nonsteroidal anti-inflammatory drugs (NSAID) to relieve mild joint aches and pains caused by the medication.

Correct Answer is ["A","B","D"]

Explanation

A) Tendon pain or swelling can be a sign of tendinitis or tendon rupture, which can be serious side effects of ciprofloxacin. Therefore, it is crucial for the client to report any tendon pain or swelling to the healthcare provider immediately.

B) Ciprofloxacin can increase sensitivity to sunlight, leading to an increased risk of sunburn. Therefore, clients should be advised to limit exposure to sunlight and avoid tanning beds while taking this medication.

C) Crushing or mixing ciprofloxacin tablets with pudding is not recommended, as it may alter the absorption and effectiveness of the medication. Clients should swallow the tablets whole with a full glass of water.

D) Increasing fluid intake while taking ciprofloxacin is generally recommended to prevent dehydration and help flush the medication through the kidneys. Adequate hydration can also help reduce the risk of crystalluria, a potential adverse effect of ciprofloxacin.

E) Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve joint aches and pains caused by ciprofloxacin is not recommended, as NSAIDs can increase the risk of tendon problems when used with ciprofloxacin. It is important for the client to report any joint aches or pains to the healthcare provider for proper evaluation and management.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which wore prescribed because of a suspected anthrax exposure. What instruction(s) should be included in the teaching plan? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

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