Which of the following is not an appropriate nursing intervention for a patient with hypercalcemia?
A. Administering calcitonin
B. Administering calcium gluconate
C. Administering loop diuretics
D. Encouraging ambulation
Correct Answer: B. Administering calcium gluconate
Calcium gluconate is used for replacement in deficiency states. Calcium gluconate, gluceptate, or chloride (IV) provides rapid treatment in acute calcium deficit, especially in the presence of tetany or convulsions. Calcitonin and loop diuretics are used to lower serum calcium.
Option A: Calcitonin can be administered subcutaneously but in most cases, the effects are mild and limited to a few days. Promotes movement of serum calcium into bones, temporarily reducing serum calcium levels, especially in the presence of the increased parathyroid hormone.
Option C: Loop diuretics should be used with caution as even though they may enhance renal excretion, paradoxical hypercalcemia can occur due to bone resorption. Diuresis promotes renal excretion of calcium and reduces risks of fluid excess from an isotonic saline infusion.
Option D: Hypercalcemia of immobilization can be prevented by encouraging activity as tolerated and adequate hydration. The specific cause of hypercalcemia needs to be identified, and treatment directed accordingly.
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