In case of persistent hypercalcemia in an adult diagnosed with hyperparathyroidism, which intervention is primarily advised?

Rationale: A. In primary hyperparathyroidism, excessive secretion of parathyroid hormone (PTH) leads to hypercalcemia. When hypercalcemia is persistent or symptomatic, parathyroidectomy is the definitive treatment to normalize calcium levels and prevent complications such as kidney stones, osteoporosis, and neurocognitive issues. B. A high-calcium diet would worsen hypercalcemia in hyperparathyroidism. Dietary calcium intake is not used to treat this condition; instead, intake may be moderated depending on patient needs. C. While vitamin D is important for calcium metabolism, increasing vitamin D in the setting of hypercalcemia could further elevate serum calcium. Vitamin D supplementation is carefully managed and sometimes restricted in hyperparathyroidism. D. Decreasing fluids is contraindicated because patients with hypercalcemia are at risk for dehydration and kidney stones. Adequate hydration helps promote renal calcium excretion and reduce serum calcium levels.