A patient is being treated for osteomalacia with vitamin D. The patient complains of fatigue, weakness, constipation, and increased voiding of pale, dilute urine
The nurse reviews the patient's laboratory findings and notes that the serum calcium is 13 mg/dL. Which of the following interventions should the nurse anticipate?
a. Increasing the vitamin D supplements
b. Providing large amounts of oral fluids
c. Increasing the patient's dietary intake of milk, cheese, and yogurt
d. Providing calcium supplements
ANS: B
Most signs and symptoms of vitamin D toxicity occur secondary to hypercalcemia, which is demonstrated by the patient's serum calcium level. Clinical manifestations include nausea, vomiting, constipation, weakness, fatigue, polyuria, and nocturia. A high fluid intake is recommended as part of the treatment.
Vitamin D supplements would be discontinued immediately, because the patient is showing signs of toxicity.
Foods such as milk, cheese, and yogurt are high in calcium and should be eliminated. In addition, milk typically is fortified with vitamin D.
Calcium supplements would further increase calcium levels and vitamin D toxicity.
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