Which patients would the nurse monitor most closely for the development of hypercalcemia? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. A patient with a malignancy
2. A patient taking lithium
3. A patient who uses sunscreen to excess
4. A patient with hyperparathyroidism
5. A patient on complete bed rest
1,2,4,5
Rationale 1: Patients with malignancy are at risk for development of hypercalcemia due to destruction of bone or the production of hormone-like substances by the malignancy.
Rationale 2: The use of lithium and overuse of antacids can result in hypercalcemia. Hypercalcemia can result from hyperparathyroidism, which causes release of calcium from the bones, increased calcium absorption in the intestines, and retention of calcium by the kidneys.
Rationale 3: The patient who uses sunscreen to excess is more likely to have a vitamin D deficiency, which would result in hypocalcemia.
Rationale 4: Hypercalcemia can result from hyperparathyroidism, which causes release of calcium from the bones, increased calcium absorption in the intestines, and retention of calcium by the kidneys.
Rationale 5: Prolonged bed rest can result in mobilization of bone calcium into the blood.
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