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) Evaluate the client's ability to recognize the urge to defecate: Assessing the client's ability to recognize the urge to defecate is important for promoting independence in toileting. However, this assessment may not directly indicate the need for administering a laxative. It is more relevant for clients who are able to ambulate or have control over their bowel movements.

B) Determine the frequency and consistency of bowel movements: Assessing the frequency and consistency of bowel movements provides valuable information about the client's bowel function and helps determine the need for a laxative. It allows the nurse to establish a baseline and evaluate the effectiveness of interventions. Understanding the client's typical bowel pattern is crucial before administering a laxative to avoid overmedication or potential complications such as diarrhea or fecal impaction.

C) Observe the skin integrity of the client's rectal and sacral areas: Assessing skin integrity in the rectal and sacral areas is crucial for preventing pressure ulcers, especially in bedfast clients. However, it is not directly related to the need for administering a laxative.

D) Assess the client's strength in moving and turning in the bed: While assessing the client's strength and mobility is important for overall care and prevention of complications related to immobility, it may not be directly related to the need for administering a laxative. This assessment is more relevant for preventing complications such as pressure ulcers and maintaining musculoskeletal function.

A. Obtain transportation to the emergency department. B. Increase Intake of fluids and high protein foods. C. Stop taking the medication Immediately. D. Avoid hazardous activities until symptoms subside.

Correct Answer is D

Explanation

A) Obtaining transportation to the emergency department may be unnecessary at this time. The client's sy’ptoms of fatigue and dizziness are likely side effects of the new medication, baclofen, and not indicative of a medical emergency. It's es’ential to assess the severity of symptoms and provide appropriate guidance before considering emergency care.

B) Increasing intake of fluids and high-protein foods may be beneficial for overall health but is not directly related to addressing the side effects of baclofen. While adequate hydration and nutrition are essential, this recommendation may not specifically address the client's sy’ptoms of fatigue and dizziness.

C) Stopping the medication immediately without consulting a healthcare provider is not advisable. Abruptly discontinuing baclofen can lead to withdrawal symptoms and a potential worsening of muscle spasticity. It's cr’cial for the client to discuss any concerns or side effects with their healthcare provider before making any changes to their medication regimen.

D) Advising the client to avoid hazardous activities until symptoms subside is the most appropriate action. Baclofen, as a muscle relaxant, can cause dizziness and fatigue, which may impair the client's ab’lity to safely engage in activities such as driving or operating machinery. By avoiding hazardous activities, the client can reduce the risk of injury or accidents while experiencing these side effects.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?

Correct Answer is B

Explanation

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

Correct Answer is D

Explanation

Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?

The nurse is reviewing the client’s laboratory results. Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing “heartburn.” How should the nurse respond?

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

A client who is receiving pregabalin for fibromyalgia reports experiencing tremors in the hands. Which action should the nurse implement?