A client has been hospitalized for multiple sclerosis exacerbation and is being given high dose IV glucocorticoid steroid medications. The prescriber places new orders for weight based sliding scale insulin. The patient asks why they need insulin. Are they now diabetic? What is the nurse's best response?
Insulin is commonly given to all hospitalized clients.
You likely developed diabetes prior to hospitalization, but are just now being diagnosed.
You have developed type 1 diabetes and will need insulin for the rest of your life.
Glucocorticoid steroid medications can cause temporary hyperglycemia.
The Correct Answer is D
Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.
Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.
Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.
Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This choice is incorrect because stomach distension and constipation are not common side effects of furosemide. They may be related to other causes, such as diet, fluid intake, or medication interactions. The nurse should assess the client's abdominal status and bowel habits and provide appropriate interventions, such as increasing fiber, fluids, or laxatives.
Choice B reason: This choice is incorrect because IV site irritation, redness, and pain are not specific side effects of furosemide. They may be caused by other factors, such as infection, infiltration, or phlebitis. The nurse should inspect the IV site and catheter and change them if needed. The nurse should also monitor the client's vital signs and blood cultures for signs of infection.
Choice C reason: This choice is correct because hearing loss or impairment is a rare but serious side effect of furosemide. It can occur due to damage to the inner ear or the auditory nerve. It may be temporary or permanent, depending on the dose and duration of furosemide therapy. The nurse should stop the infusion of furosemide and notify the provider immediately. The nurse should also assess the client's hearing and balance and provide safety measures.
Choice D reason: This choice is incorrect because frequent urination is an expected effect of furosemide. Furosemide is a diuretic that increases the excretion of water and electrolytes through the urine. It helps to reduce fluid overload and edema in clients with heart failure. The nurse should measure and record the client's intake and output and monitor the client's fluid and electrolyte status.
Correct Answer is C
Explanation
Choice A reason: This is incorrect. Dry cough and nose bleed are not common side effects of gemfibrozil. They may indicate other conditions, such as allergies, infections, or bleeding disorders.
Choice B reason: This is incorrect. Constipation and dry skin are not common side effects of gemfibrozil. They may be caused by dehydration, dietary factors, or other medications.
Choice C reason: This is correct. Abdominal pain and jaundice are serious side effects of gemfibrozil. They may indicate liver damage, which can be fatal if not treated promptly. The client should report these symptoms to the prescriber immediately.
Choice D reason: This is incorrect. Hirsutism and flatulence are not common side effects of gemfibrozil. They may be associated with hormonal imbalances, digestive disorders, or other causes.
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