[Answered]: GROUP “C”- Case Study A postoperative client who…

GROUP “C”- Case Study A postoperative client who had a thyroidectomy 2 days ago reports fatigue and anxiety. The client states, “My hands are asleep and I feel prickly pins around my mouth.” The client has a history of goiter, hypertension, alcoholism, and anxiety. The client has no known allergies but says she has a dietary intolerance to lactose. The client’s current list of medications is: Atenolol 50 mg daily Aspirin 81 mg daily Triamterene/hydrochlorothiazide 1 capsule daily Slow-K 20 mEq daily Estrogen 0.3 mg daily Fleet’s Phospho-soda PRN constipation Nursing Assessment: 1. Alert; irritable; anxious; oriented to person, place, and time 2. Heart sounds S1 and S2 regular, slow 3. Hypotensive 4. Trousseau’s sign and Chvostek’s sign present 5. Deep tendon reflexes 3+ bilaterally 6. Pedal and radial pulses regular, 1+ and weak bilaterally 7. Bowel sounds hyperactive in all four quadrants 8. Pedal and radial pulses regular, 1+, and weak bilaterally 9. ECG shows sinus bradycardia with prolonged ST segment Vital Signs Laboratory Results Temperature: 97.8° F orally Serum Ca+ 7.4 mg/dL B/P (sitting): 90/60 Ionized calcium 3.2 mg/dL Heart rate: 58 bpm, regular Serum phosphate 4.9 mg/dL Respiratory rate: 20 Serum magnesium 1.3 mEq/L O2 saturation: 97% Serum potassium 3.5 mEq/L Serum albumin 2.5 g/dL (normal 3.4- 5.4 g/dL) Vitamin D 8 ng/dL (normal 20- 50 ng/dL) Health Care Provider Prescription 1. 0.9% saline solution IV 1,000 mL at 125 mL/hr 2. Start telemetry and monitor closely during calcium administration 3. Vital signs every 15 minutes x 1 hour and then every 30 minutes x 1 hour, then every 4 hours if stable 4. Administer 10% calcium gluconate IV 30 mL over no less than 15 now and every 6 hours x 2 doses 5. Hold atenolol and triamterene/hydrochlorothiazide 6. Implement seizure precautions and fall precautions 7. Monitor intake and output 8. Reevaluate clinical signs and symptoms; repeat ECG, serum calcium, ionized calcium, magnesium, phosphate, and potassium in 6 hours; notify HCP of results – The oncoming nurse notes that D5 and 0.9% NS is infusing with approximately 1⁄2 of a liter bag infused. After changing to the correct fluid, what would be the priority assessments?