The nurse is teaching a patient with hyperparathyroidism how to manage the condition at home.
Which response by the patient indicates the need for additional teaching?

Choice A rationale

An increase in systolic blood pressure by 25 mmHg indicates a positive response to therapy for Addisonian crisis. Addisonian crisis involves severe hypotension due to low levels of cortisol and aldosterone, which regulate blood pressure. Cortisol replacement therapy helps to increase blood pressure by enhancing the responsiveness of blood vessels to catecholamines and promoting sodium and water retention. This improvement is critical for stabilizing the patient and restoring hemodynamic balance.

Choice B rationale

An increase in serum potassium level from 3.5 to 5.6 mEq/dL suggests hyperkalemia, which is a sign of worsening condition, not improvement. Addisonian crisis is characterized by hyperkalemia due to aldosterone deficiency, which impairs potassium excretion. Effective treatment would normalize potassium levels rather than increase them.

Choice C rationale

Complaints of headache and signs of restlessness may indicate adverse effects or complications, rather than therapeutic efficacy. These symptoms could result from inadequate or excessive dosing of corticosteroids or other underlying issues. Monitoring patient response and adjusting treatment is essential.

Choice D rationale

Normal temperature with pallor to the skin does not indicate effective therapy for Addisonian crisis. Pallor may reflect ongoing hypoperfusion or anemia. The absence of fever is not a definitive marker of therapeutic success. Key indicators include hemodynamic stability and normalized electrolytes.

The correct answer is Choice D.

Choice A rationale

Monitoring for flu-like symptoms during immunotherapy infusions is crucial because these medications can cause cytokine release syndrome. Symptoms like fever, chills, fatigue, and muscle aches are common side effects of immunotherapy and require close monitoring to manage and mitigate adverse reactions.

Choice B rationale

Immunotherapy generally does not cause hair loss, unlike traditional chemotherapy. Hair loss occurs because chemotherapy targets rapidly dividing cells, including hair follicle cells. Immunotherapy works by enhancing the body's immune response to cancer cells without targeting hair follicles.

Choice C rationale

Immunotherapy leverages the patient's immune system to recognize and attack cancer cells. It enhances the body's natural defenses by boosting immune system activity or by counteracting signals produced by cancer cells that suppress immune responses.

Choice D rationale

Immunotherapy does not prevent hospital-acquired infections. While it strengthens the immune system against cancer, it does not provide general protection against pathogens causing nosocomial infections. Patients undergoing immunotherapy should still follow standard precautions to avoid infections.