A patient reports experiencing weakness, fatigue, nausea, vomiting, constipation, and nocturia. A dipstick urinalysis shows a positive result for protein. When questioned, the patient reports taking vitamin D and calcium supplements
The nurse will counsel the patient to:
a. reduce the amount of vitamin D and stop taking the calcium.
b. discuss taking calcitonin-salmon (Fortical) with the provider.
c. stop both supplements and discuss the use of a diuretic with the provider.
d. stop taking vitamin D, reduce the amount of calcium, and increase the fluid intake.
ANS: D
Vitamin D toxicity can occur, and early responses include the symptoms described. Patients should be counseled to stop taking vitamin D, reduce their calcium intake, and increase their fluid intake. It is not correct to reduce the vitamin D intake and the calcium intake. Calcitonin-salmon is not indicated. A diuretic is indicated when hypercalciuria is severe.
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