The nurse is managing the care for a client with hyperparathyroidism, and is reviewing the client's list of prescribed and over-the- counter medications. Which medication(s) on the client's current medication record should the nurse discuss further with the healthcare provider? Select all that apply.
Explanation & Rationale
A. Hydrochlorothiazide: Thiazide diuretics reduce calcium excretion by the kidneys, which can increase serum calcium levels and worsen hypercalcemia in clients with hyperparathyroidism. B. Acetaminophen: Acetaminophen is not known to affect calcium or parathyroid function, so it is generally safe for pain or fever management in these clients. C. Lithium carbonate: Lithium can increase parathyroid hormone secretion, thereby exacerbating hyperparathyroidism and hypercalcemia, making it a medication of concern. D. Calcium carbonate: Calcium supplements can further raise serum calcium levels in clients with hyperparathyroidism, increasing the risk of renal stones or cardiac complications, and should be reviewed. E. Sodium phosphate supplement: Phosphate supplements can actually lower calcium levels and may be used therapeutically in some cases of hyperparathyroidism, so they are not typically contraindicated.