The nurse is managing the care for a client with hyperparathyroidism and is reviewing the client's list of prescribed and over-the-counter medications.

Which medication(s) on the client's current medication record should the nurse discuss further with the healthcare provider? Select all that apply.

Calcium carbonate.

Acetaminophen.

Hydrochlorothiazide.

Lithium carbonate.

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale

Calcium carbonate is a common medication used to manage low calcium levels, but in clients with hyperparathyroidism, it can exacerbate hypercalcemia, leading to dangerous levels of calcium in the blood. Hyperparathyroidism already causes increased calcium release from bones, increased absorption from the intestines, and decreased excretion by the kidneys, so adding calcium carbonate can worsen these effects, potentially leading to complications like kidney stones, bone pain, and cardiovascular issues. Careful monitoring and possible dose adjustments or discontinuation might be necessary.

Choice B rationale

Acetaminophen is an analgesic and antipyretic commonly used for pain relief and fever reduction. It is metabolized primarily in the liver and does not significantly impact calcium levels or parathyroid hormone function. Therefore, it does not pose an immediate concern for clients with hyperparathyroidism and can typically be used safely without requiring further discussion with the healthcare provider unless there are other contraindications or hepatic issues in the client's medical history.

Choice C rationale

Hydrochlorothiazide is a thiazide diuretic often used to manage hypertension and edema. It reduces urine calcium excretion, which can lead to increased serum calcium levels, exacerbating hypercalcemia in clients with hyperparathyroidism. Thiazide diuretics promote calcium reabsorption in the distal convoluted tubules of the kidneys, potentially worsening the hypercalcemia caused by hyperparathyroidism. Therefore, the use of hydrochlorothiazide should be carefully evaluated and potentially avoided in these clients.

Choice D rationale

Lithium carbonate is used to treat bipolar disorder and can affect parathyroid function, leading to increased parathyroid hormone (PTH) levels and hypercalcemia. Lithium can alter the set point of the calcium-PTH feedback loop, leading to increased release of PTH, even at normal calcium levels. This can result in worsening hyperparathyroidism and hypercalcemia, making it a medication that requires careful consideration and monitoring in affected clients.

Choice E rationale

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Correct Answer is D

Explanation

Choice A rationale

The client's healthcare power of attorney is important information but not the most urgent detail to report when there is a sudden change in the client's condition. Immediate clinical changes take priority.

Choice B rationale

The fall at home as the reason for admission provides background information but does not address the urgent change in the client's mental status. The primary focus should be on the sudden increase in confusion.

Choice C rationale

Currently prescribed medications are important to consider, especially if they could contribute to the client's confusion. However, the sudden change in mental status is more critical to report first.

Choice D rationale

Increasing confusion of the client is the most urgent information to report. It indicates a significant change in the client's condition that requires immediate assessment and intervention by the healthcare provider. Identifying and addressing the cause of this change is crucial to prevent further complications.

Correct Answer is ["0.75"]

Explanation

Step 1 is 0.1875 mg ÷ 0.25 mg/mL Step 2 is 0.75 mL Final answer: 0.75 mL.

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The nurse is managing the care for a client with hyperparathyroidism and is reviewing the client's list of prescribed and over-the-counter medications. Which medication(s) on the client's current medication record should the nurse discuss further with the healthcare provider? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is ["0.75"]

Explanation

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