Page 1834 - Saunders Comprehensive Review For NCLEX-RN

stimulation of parathyroid hormone,
causing bone demineralization.
b. Treatment is aimed at lowering the
serum phosphorus level.

c. Administer phosphate binders

as prescribed with meals to lower
serum phosphate levels.

d. Administer stool softeners and

laxatives as prescribed, because
phosphate binders are constipating.
e. Teach the client about the need to limit
the intake of foods high in phosphorus
(see Chapter 11 for a list of foods that
are high in phosphorus).
7. Hypertension
a. Caused by failure of the kidneys to
maintain BP homeostasis.
b. Monitor vital signs for elevated BP.
c. Maintain fluid and sodium restrictions
as prescribed.
d. Administer diuretics and
antihypertensives as prescribed.
8. Hypervolemia
a. Monitor vital signs for an elevated BP.
b. Monitor intake and output and

daily weight for indications of fluid
retention.
c. Monitor for periorbital, sacral, and
peripheral edema.
d. Monitor the serum electrolyte levels.
e. Monitor for hypertension and notify the
PHCP if there are sustained elevations.

f. Monitor for signs of heart failure

and pulmonary edema, such as
restlessness, heightened anxiety,
tachycardia, dyspnea, basilar lung
crackles, and blood-tinged sputum;
notify the PHCP immediately if signs
occur.
g. Maintain fluid restriction.
h. Avoid the administration of large
amounts of IV fluids.
i. Administer diuretics as prescribed.

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