The mother of an adolescent male tells the clinic nurse that she found anabolic steroids in her son's room. How should the nurse respond? Select all that apply.

A. Hold both medications until contacting the healthcare provider (HCP): A total calcium level of 14 mg/dL is critically high and indicates hypercalcemia. Continuing calcitriol or calcium carbonate could worsen the hypercalcemia, so both medications should be held and the HCP contacted immediately for further orders.

B. Hold the calcitriol, but administer the calcium carbonate as scheduled: Calcium carbonate increases serum calcium levels, and administering it would exacerbate the already dangerously high calcium level. It should not be given until the situation is reassessed.

C. Hold the calcium carbonate, but administer the calcitriol as scheduled: Calcitriol promotes intestinal absorption of calcium, which could further elevate serum calcium levels. Giving calcitriol would be unsafe until the client’s calcium status is re-evaluated.

D. Administer both prescribed medications as scheduled: Administering both medications would significantly increase the risk of severe hypercalcemia complications, such as cardiac arrhythmias or neurologic changes, and must be avoided until new instructions are received.

A. Describe how anabolic steroids increase muscle strength to improve athletic performance: While anabolic steroids do enhance muscle mass and strength, emphasizing this could inadvertently normalize or encourage their misuse rather than addressing the serious health risks involved.

B. Advise of the need to observe for changes in behavior, such as increased aggression: Anabolic steroids can cause mood disturbances, including aggression, irritability, and even psychiatric symptoms. Educating the parent to monitor for behavioral changes is critical for early intervention.

C. Explain that this is a schedule II controlled substance: Anabolic steroids are actually classified as Schedule III controlled substances under the Controlled Substances Act, not Schedule II. Providing inaccurate information could lead to confusion and mismanagement of the situation.

D. Encourage a clinic visit to assess the adolescent for cardiovascular complications: Steroid use can increase the risk of serious cardiovascular problems like hypertension, lipid abnormalities, and myocardial damage. Prompt medical evaluation is essential to detect early complications.

E. Identify the use of any other herbal supplements: Adolescents who misuse anabolic steroids may also be using other supplements or substances that could have dangerous interactions. A full assessment of all substances being used is important for comprehensive care and counseling.