Podcast
Questions and Answers
A nurse is teaching a client how to self-administer intranasal calcitonin. Which instruction should the nurse include?
A nurse is teaching a client how to self-administer intranasal calcitonin. Which instruction should the nurse include?
- Use the same nostril for each administration to ensure consistent absorption.
- Store the medication at room temperature away from light.
- Administer the spray while lying down to prevent nasal irritation.
- Prime the pump of the new container prior to the first use. (correct)
A client taking calcitonin reports tingling in their fingers and muscle spasms. What is the priority action for the nurse?
A client taking calcitonin reports tingling in their fingers and muscle spasms. What is the priority action for the nurse?
- Instruct the client to monitor the adverse effect.
- Advise the client to reduce their sodium consumption.
- Instruct the client to notify their provider immediately. (correct)
- Instruct the client to increase their potassium intake.
A client with a history of salmon allergy is prescribed calcitonin. What is the most appropriate nursing action?
A client with a history of salmon allergy is prescribed calcitonin. What is the most appropriate nursing action?
- Administer a test dose of calcitonin and monitor for a reaction.
- Administer the medication with epinephrine available.
- Educate the client about potential side effects.
- Confirm that this is a safe medication with the provider due to the allergy. (correct)
A client is prescribed both lithium and calcitonin. What nursing intervention is most important?
A client is prescribed both lithium and calcitonin. What nursing intervention is most important?
A client has been taking calcitonin for 2 years. What assessment is most important for the nurse to monitor?
A client has been taking calcitonin for 2 years. What assessment is most important for the nurse to monitor?
Which of the following instructions regarding calcitonin administration should the nurse include when teaching a client?
Which of the following instructions regarding calcitonin administration should the nurse include when teaching a client?
A postmenopausal client is prescribed calcitonin. What dietary instruction is most important for the nurse to emphasize?
A postmenopausal client is prescribed calcitonin. What dietary instruction is most important for the nurse to emphasize?
A client is receiving calcitonin via subcutaneous injection. What action promotes client safety?
A client is receiving calcitonin via subcutaneous injection. What action promotes client safety?
A client with hyperparathyroidism is prescribed calcitonin. What is the primary expected outcome of this medication in this client?
A client with hyperparathyroidism is prescribed calcitonin. What is the primary expected outcome of this medication in this client?
Which of the following assessment findings would warrant withholding calcitonin and notifying the healthcare provider?
Which of the following assessment findings would warrant withholding calcitonin and notifying the healthcare provider?
A client is prescribed injectable calcitonin salmon. Which instruction should the nurse include in the client's teaching plan regarding potential adverse effects?
A client is prescribed injectable calcitonin salmon. Which instruction should the nurse include in the client's teaching plan regarding potential adverse effects?
A client is prescribed calcitonin for long-term management of osteoporosis. What should the nurse emphasize to maximize the therapeutic effects of the medication?
A client is prescribed calcitonin for long-term management of osteoporosis. What should the nurse emphasize to maximize the therapeutic effects of the medication?
When administering calcitonin nasal spray to a client, what is the most important action for the nurse to take prior to administration?
When administering calcitonin nasal spray to a client, what is the most important action for the nurse to take prior to administration?
A nurse is caring for a client receiving calcitonin. Which of the following findings would indicate a therapeutic effect of the medication?
A nurse is caring for a client receiving calcitonin. Which of the following findings would indicate a therapeutic effect of the medication?
A client with a known fish allergy is prescribed calcitonin salmon. What is the most appropriate nursing action?
A client with a known fish allergy is prescribed calcitonin salmon. What is the most appropriate nursing action?
A client receiving calcitonin reports tingling in their fingers and toes. Which electrolyte imbalance should the nurse suspect?
A client receiving calcitonin reports tingling in their fingers and toes. Which electrolyte imbalance should the nurse suspect?
Flashcards
Calcitonin
Calcitonin
A hormone that decreases bone resorption, used to treat osteoporosis, hypercalcemia, and Paget's disease.
Calcitonin's Action
Calcitonin's Action
Inhibits osteoclasts to prevent bone breakdown and increases calcium excretion.
Calcitonin Contraindications
Calcitonin Contraindications
Clients with salmon protein or gelatin allergies.
Hypocalcemia Signs
Hypocalcemia Signs
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Calcitonin Diet
Calcitonin Diet
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Calcitonin Allergy Test
Calcitonin Allergy Test
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Calcitonin Nasal Spray Side Effects
Calcitonin Nasal Spray Side Effects
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Calcitonin Injectable Form Side Effects
Calcitonin Injectable Form Side Effects
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Intranasal Calcitonin Administration
Intranasal Calcitonin Administration
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Subcutaneous/Intramuscular Calcitonin Administration
Subcutaneous/Intramuscular Calcitonin Administration
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Calcitonin Storage
Calcitonin Storage
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Importance of Client Teaching (Calcitonin)
Importance of Client Teaching (Calcitonin)
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Calcitonin - Reportable Side Effects
Calcitonin - Reportable Side Effects
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Calcitonin - Diet and Monitoring
Calcitonin - Diet and Monitoring
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Calcitonin-Lithium Interaction
Calcitonin-Lithium Interaction
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Study Notes
- Calcitonin cannot prevent osteoporosis, unlike SERMs, bisphosphonates, and calcium supplements
- It treats established postmenopausal osteoporosis, hypercalcemia (secondary to hyperparathyroidism), and Paget’s disease
Prototype Medication
- Calcitonin salmon is the prototype and only medication in its classification
Medication Classification
- Hypocalcemic
Expected Pharmacologic Action
- Decreases bone resorption
- Functions similarly to calcitonin produced by the thyroid gland
- Inhibits osteoclasts, preventing bone tissue breakdown
- Increases calcium excretion
- Decreases serum calcium in clients with hypercalcemia
Adverse Drug Reactions
- Hypersensitivity reactions and anaphylaxis in clients with salmon protein or gelatin diluent allergies
- Hypocalcemia if calcium excretion exceeds intake
- Nasal dryness and irritation, headaches, and epistaxis with the nasal form
- Injection site reactions, nausea, vomiting, and polyuria with the injectable form
- Decreased therapeutic effects with long-term use
Interventions
- Assess nostrils for irritation or ulceration before intranasal administration
- Monitor for hypocalcemia manifestations like muscle spasms and tingling in fingers/toes, and check serum calcium levels
- Provide a diet high in calcium and vitamin D when treating osteoporosis with calcitonin salmon
- Perform an intradermal allergy test before therapy
Safety Alert
- Anaphylactic shock can occur in clients allergic to salmon or fish protein
- Erythema development within 15 minutes in allergy test indicates sensitivity: Withhold the medication if this occurs
- Even without an allergic reaction, keep antihistamines, oxygen, and epinephrine (1:1000 concentration) available during the first few days of therapy
Administration
- Hold the nasal pump upright when administering intranasally
- Prime the pump before first use by following the manufacturer’s instructions
- Spray once in a nostril, alternating nostrils daily
- Rotate injection sites for subcutaneous or intramuscular administration
- Protect parenteral calcitonin from light and refrigerate it
Client Instructions
- Self-administer calcitonin properly (especially intranasally)
- Prime the pump for each new container before first use, following the manufacturer’s instructions
- Alternate nostrils daily during administration
- Report nasal irritation or bleeding
- Immediately notify provider if rash, itching, muscle spasms, or tingling of fingers/toes occurs
- Consume a diet high in calcium and vitamin D
- Calcitonin may lose effectiveness after a year or more of use, so regular bone density studies are needed
Contraindications and Precautions
- Contraindicated in clients allergic to salmon or other fish protein
Interactions
- Calcitonin may decrease serum lithium levels in clients taking lithium, so monitor lithium levels closely
- Previous bisphosphonate treatment (alendronate, risedronate, etidronate, ibandronate, or pamidronate) may decrease the body's response to calcitonin
Question Answer
- When considering the adverse effects of calcitonin, the nurse should instruct the client to increase calcium and vitamin D intake.
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Description
Calcitonin, a hypocalcemic medication, is used to treat established postmenopausal osteoporosis, hypercalcemia, and Paget’s disease. It inhibits osteoclasts, reducing bone resorption and increasing calcium excretion. Adverse effects include hypersensitivity reactions, hypocalcemia, nasal issues, injection site reactions, nausea, vomiting and polyuria.
