Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the total level of calcium is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?
Administer both prescribed medications as scheduled.
Hold the calcitriol but administer the calcium carbonate as scheduled.
Hold the calcium carbonate but administer the calcitriol as scheduled.
Hold both medications until contacting the healthcare provider.
The Correct Answer is D
A total calcium level of 14 mg/dL (3.5 mmol/L) is higher than the normal range of 2.2 to 2.6 millimoles per liter (mmol/L)1. Calcitriol and calcium carbonate are both medications used to increase calcium levels in the blood2. Since the client’s calcium level is already high, it would be important for the nurse to hold both medications and contact the healthcare provider for further instructions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Atorvastatin is a medication used to lower cholesterol levels in the blood. One of its side effects is muscle damage, which can result in an increase in serum creatine phosphokinase (CK) levels. Creatine phosphokinase is an enzyme found in muscles, and when muscles are damaged, CK is released into the bloodstream. Therefore, an increased serum CK level indicates muscle damage, and the nurse should assess the client for muscle tenderness or weakness, which are symptoms of this side effect. Nausea and vomiting, excessive bruising, and peripheral edema are not typically associated with atorvastatin use.
Correct Answer is C
Explanation
The correct answer is C. Instruct the client to request assistance when ambulating to the bathroom.
Choice A reason:
Advise the client that the medication should start to work in about 30 minutes.
While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.
Choice B reason:
Administer a stool softener/laxative at the same time as the analgesic.
Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.
Choice C reason:
Instruct the client to request assistance when ambulating to the bathroom.
This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.
Choice D reason:
Tell the client to notify the nurse if the pain is not relieved.
While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.
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