The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L
The nurse checks to see that which of the following medications is available in the stock medication supply for possible use to reverse this elevation? 1. Vitamin D
2. Calcium chloride
3. Calcium gluconate
4. Calcitonin
4
Rationale: The normal serum calcium level is 4.5 to 5.5 mEq/L or 9 to 11 mg/dL. Calcitonin, a thyroid hormone, decreases the plasma calcium level by increasing the incorporation of calcium into the bones, thus keeping it out of the serum. In hypercalcemia, large doses of vitamin D should be avoided. Calcium gluconate and calcium chloride would be used to treat tetany that results from acute hypocalcemia.
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A nurse reviews vital signs for a patient admitted last night with an injury sustained while intoxicated
The medical record shows these blood pressure and pulse readings: Admission, 2 AM - 118/78 mm Hg and 72 beats/min 4 AM - 126/80 mm Hg and 76 beats/min 6 AM - 128/82 mm Hg and 72 beats/min 8 AM - 132/88 mm Hg and 80 beats/min 10 AM - 148/94 mm Hg and 96 beats/min What is the nurse's priority action? a. Force fluids. b. Consult the health care provider. c. Obtain a clean-catch urine sample. d. Place the patient in a vest-type restraint.
Using critical thinking, the nurse assesses that a patient is not a reliable historian. How should the nurse proceed?
1. Stop the assessment because all data is invalid. 2. Document that the patient is not answering questions truthfully. 3. Ask different questions to assess the same information. 4. Document the information just as the patient reports it.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?
a. Hematocrit of 35% b. Hemoglobin of 11.8 g/dL c. Platelet count of 400,000/µL d. White blood cell (WBC) count of 2800/µL
The nurse cleansing the skin surface of a patient prior to injection will start at the
a. periphery and work inward in a back and forth motion. b. periphery and work inward in a cyclical motion. c. injection site and work outward in a straight line. d. injection site and work outward in a circular motion.