The nurse is reviewing the laboratory results of a client who reports taking five times the recommended daily allowance of vitamins and minerals in a multivitamin form. Which finding indicates a possible vitamin D overdose?

Reference Range:

Bilirubin [0.3 to 1 mg/dL (5.1 to 17 μmol/L)]

Calcium 19 to 10.5 mg/dL (2.3 to 2.6 mmol/L)]

Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Blood Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Sodium level 140 mEq/L (140 mmol/L).

Total calcium level 12 mEq/L (3 mmol/L).

Total bilirubin 4 mg/dL (68.4 μmol/L).

Serum glucose 170 mg/dL (9.4 mmol/L).

Answer and Explanation

The Correct Answer is B

A) Sodium level 140 mEq/L (140 mmol/L):
The sodium level within the reference range does not indicate a vitamin D overdose. Sodium levels are typically not affected by vitamin D overdose.

B) Total calcium level 12 mg/dL (3 mmol/L):
This finding suggests a possible vitamin D overdose. Vitamin D plays a crucial role in calcium absorption from the intestines. Excessive vitamin D intake can lead to increased calcium absorption, resulting in hypercalcemia. Elevated calcium levels can lead to various symptoms such as nausea, vomiting, weakness, and confusion. Monitoring calcium levels is essential in individuals with suspected vitamin D overdose.

C) Total bilirubin 4 mg/dL (68.4 μmol/L):
Elevated bilirubin levels typically indicate liver dysfunction or hemolysis. It is not directly related to vitamin D overdose.

D) Serum glucose 170 mg/dL (9.4 mmol/L):
Elevated glucose levels suggest hyperglycemia, which can occur due to various factors such as diabetes mellitus or stress response. It is not directly related to vitamin D overdose.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A) Worsening headache:
This option is correct. Vasopressin, also known as antidiuretic hormone (ADH), acts to increase water reabsorption in the kidneys, thereby reducing urine output. However, excessive administration of vasopressin can lead to vasoconstriction, which may result in increased intracranial pressure and subsequent headaches. Therefore, worsening headache can be indicative of vasopressin overdose or adverse effects, and it should be promptly reported to the healthcare provider for evaluation and appropriate management.

B) Polyuria:
Polyuria, or excessive urine output, is the opposite effect of vasopressin. While diabetes insipidus is characterized by polyuria due to insufficient ADH secretion or renal responsiveness to ADH, administering vasopressin should decrease urine output. Therefore, polyuria would not be expected as a side effect of vasopressin administration.

C) Polydipsia:
Polydipsia, or excessive thirst, is also a symptom of diabetes insipidus but is not typically associated with vasopressin administration. Vasopressin functions to decrease urine output and, consequently, reduce thirst. Therefore, polydipsia would not be expected as a side effect of vasopressin administration.

D) Low urine specific gravity:
Vasopressin administration is expected to increase urine specific gravity by promoting water reabsorption in the kidneys, leading to more concentrated urine. Therefore, low urine specific gravity would not be an expected side effect of vasopressin administration.

A. Obtain a soft bristle toothbrush for client. B. Provide a PRN nonsteroidal anti-inflammatory (NSAID) for gum discomfort. C. Review most recent coagulation lab values. D. Report findings to healthcare provider. E. Complete a medication variance report.

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

Explanation

A) Obtain a soft bristle toothbrush for the client:
This is an appropriate action because bleeding and tender gums can indicate oral bleeding, which may be exacerbated by the use of a standard toothbrush. Switching to a soft bristle toothbrush can help minimize trauma to the gums and reduce bleeding.

B) Provide a PRN nonsteroidal anti-inflammatory drug (NSAID) for gum discomfort:
Administering NSAIDs in this situation is not recommended. NSAIDs can further increase the risk of bleeding due to their antiplatelet effects. Therefore, providing an NSAID could exacerbate the client’s bleeding symptoms.

C) Review most recent coagulation lab values:
This is a crucial action to assess the client’s coagulation status and determine if the bleeding and bruising are related to anticoagulant therapy. Reviewing coagulation lab values, such as prothrombin time (PT) and international normalized ratio (INR), can provide important information about the client’s clotting function and guide further management.

D) Report findings to the healthcare provider:
This is essential to ensure timely evaluation and management of the client’s symptoms. Bleeding and bruising after anticoagulant therapy may indicate an increased risk of bleeding complications, and the healthcare provider needs to be informed promptly for further assessment and possible adjustment of the anticoagulant regimen.

E) Complete a medication variance report:
While documenting the client’s symptoms and actions taken is important for quality assurance and tracking adverse events, completing a medication variance report may not be the immediate priority in this situation. The focus should be on assessing the client’s condition, managing symptoms, and communicating with the healthcare provider for appropriate intervention

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Naxlex Comprehensive Predictor Exams

A client who is newly diagnosed with diabetes insipidus is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?

Correct Answer is A

Explanation

After receiving the third dose of a new oral anticoagulant prescription, an older client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

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

Explanation

A client is receiving morphine sulfate via a patient controlled analgesic (PCA) pump postoperatively. Which assessment finding should prompt the nurse to administer a prescribed PRN dose of naloxone?

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

A client who is experiencing vasomotor symptoms related to menopause receives a new prescription for estrogen replacement. Which client condition should the nurse report the healthcare provider prior to administering the first dose of the medication?

A client receives a prescription for dextrose 5% in water 500 mL IV to be infused over 4 hours. The IV administration set delivers 15 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?