Final answer:
The nurse should educate the client with metastatic bone disease on recognizing and managing symptoms of hypercalcemia, such as lethargy and sluggish reflexes, rather than tetany. Preventive measures include staying hydrated, managing dietary calcium and vitamin D intake, and remaining active.
Step-by-step explanation:
It is important for the nurse to teach a client with metastatic bone disease about measures to prevent hypercalcemia, which is characterized by abnormally high levels of calcium leading to a variety of symptoms. Rather than emphasizing early recognition of findings associated with tetany, which is related to low calcium levels, the nurse should focus on helping the client identify and manage symptoms indicative of high calcium levels. These can include lethargy, sluggish reflexes, constipation, loss of appetite, confusion, and in severe cases, coma. Measures to help prevent hypercalcemia include maintaining hydration to help with calcium excretion, avoiding excessive intake of calcium and vitamin D, and staying active to prevent bone resorption of calcium.
Understanding the mechanisms of calcium homeostasis and the roles of hormones such as PTH, vitamin D, and calcitonin can also aid in managing and preventing hypercalcemia. These hormones regulate the movement of calcium between the bones, kidneys, and intestine, maintaining the necessary balance for normal body functions. For patients with conditions like hyperparathyroidism, preventing calcium reabsorption from bones is crucial, as it leads to heightened calcium levels in the blood, decreasing bone density and potentially causing spontaneous fractures or deformities.