The nurse is caring for a patient who will receive intravenous calcium gluconate. Which nursing actions are appropriate when giving this solution? (Select all that apply.)
a. Administering through a central line
b. Assessing for Trousseau's and Chvostek's signs
c. Giving as a rapid intravenous bolus
d. Mixing in a solution containing sodium bicarbonate
e. Monitoring the patient's electrocardiogram (ECG)
f. Reporting a serum calcium level >2.5mEq/L
ANS: B, E, F
Trousseau's and Chvostek's signs indicate hypocalcemia, and patients receiving calcium should be monitored closely for signs of calcium imbalance. Hypercalcemia can cause ECG changes. A serum calcium level greater than 2.5mEq/L indicates hypercalcemia and therefore should be reported. Calcium does not require infusion through a central line and should not be given as a rapid IV bolus. Calcium should not be added to a solution containing bicarbonate, because rapid precipitation occurs.
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