A nurse teaches a client newly prescribed cinacalcet for sec… | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a client newly prescribed cinacalcet for secondary hyperparathyroidism in CKD. Which monitoring instruction is essential?
1Check serum phosphate levels regularly — hyperphosphatemia is a frequent effect of cinacalcet; symptoms include itching, bone pain, and calciphylaxis.
2Serum calcium routinely — hypocalcemia is a common adverse effect of cinacalcet; symptoms include perioral tingling, muscle cramps, and seizures✓ Correct answer
3Monitor for elevated calcium signs each visit — hypercalcemia is a potential adverse effect of cinacalcet; symptoms include nausea, vomiting, and confusion.
4Record daily body weight each morning — fluid retention is a known effect of cinacalcet; signs include edema, shortness of breath, and fatigue.
Explanation
Correct (2): Cinacalcet activates the calcium-sensing receptor of the parathyroid gland → lowers PTH AND lowers serum calcium. Routine Ca monitoring; hold if Ca
In-depth explanation
Memory Tip Cinacalcet = "Calcimimetic mimics Ca to suppress PTH; serum Ca DROPS." Lab monitoring is Ca, P, PTH every 1-3 months.
Clinical scenario
Scenario 60-year-old male CKD on dialysis starting cinacalcet 30 mg PO daily for elevated PTH.
Key concepts
Cinacalcet — Calcimimetic for secondary hyperparathyroidism; etelcalcetide IV alternative.
Hypocalcemia from cinacalcet — Common adverse effect; monitor Ca and educate symptoms.
CKD-MBD therapies — Vit D analog (calcitriol), calcimimetic (cinacalcet), phosphate binders, parathyroidectomy.