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A patient who is to be discharged after being diagnosed with multiple myeloma is given instructions by the nurse. It is very important for the nurse to remind the patient to:

Explanation

•Anorexia and nausea that persists in patients with multiple myeloma are showing signs of hypercalcemia that should be reported to the physician. Severe hypercalcemia can be life-threatening.

•An increased level of calcium in the bloodstream is common with multiple myeloma. Patients who are diagnosed with multiple myeloma must be taught to monitor for the signs of hypercalcemia and they must be told to report those signs to the physician immediately. Other signs include vomiting, polyuria, weakness and fatigue, constipation, and signs of dehydration.

•A high calorie diet may be helpful but low-fiber diet can lead to constipation.

•Activity is advised rather than complete bed rest because it can promote hypercalcemia.

•To dilute the calcium overload and prevent protein from precipitating in the renal tubules a fluid intake of at least 3000 ml/day is recommended.

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