A client has undergone surgery for the creation of burr holes after sustaining head trauma from a fall and is at risk for developing an infection. An early critical manifestation of meningeal irritation for which the nurse assesses the client is :

Choice A reason : A nagging cough can be a warning sign of cancer, particularly lung cancer. If a cough persists for weeks or longer, especially if it's accompanied by blood or sputum, it should be evaluated by a healthcare professional. Persistent coughing can also be symptomatic of laryngeal or thyroid cancer¹.

Choice B reason : A nonhealing sore that persists for more than a few weeks can be a sign of skin cancer, including melanoma, basal cell carcinoma, or squamous cell carcinoma. It's also a common sign of oral cancer, especially in individuals who use tobacco or consume excessive alcohol¹.

Choice C reason : A change in moles or other skin lesions can be an early indication of skin cancer. The ABCDE rule is a guide to the usual signs of melanoma, looking for Asymmetry, Border irregularity, Color changes, Diameter greater than 6mm, and Evolving size, shape or color².

Choice D reason : While bloating can be caused by many benign conditions, persistent bloating that doesn't go away can be a sign of ovarian or other types of abdominal cancers. It's important to consider this symptom in conjunction with other signs and symptoms¹.

Choice E reason : A change in bowel pattern, such as persistent diarrhea or constipation, can indicate colorectal cancer. Any significant changes in bowel habits that do not resolve over time warrant medical evaluation¹.

Choice A reason : When a patient stops taking oral prednisone abruptly after prolonged use, the body may not immediately resume normal production of cortisol, which is a hormone that prednisone mimics. This can lead to adrenal insufficiency, a condition where the body produces insufficient amounts of cortisol. Symptoms can include fatigue, weakness, weight loss, abdominal pain, and low blood pressure¹². It is crucial for patients to understand the need to taper off the medication gradually under medical supervision to avoid this potentially serious condition.

Choice B reason : Memory complications are not typically associated with the sudden cessation of prednisone. While some patients may experience mood swings or cognitive changes while taking prednisone, these are not the primary concerns when discontinuing the medication.

Choice C reason : Cardiovascular complications are not directly related to the sudden stoppage of prednisone. However, adrenal insufficiency can indirectly affect cardiovascular health due to the role of cortisol in maintaining blood pressure and cardiovascular function.

Choice D reason : Psychosis is a possible side effect of taking prednisone, especially at high doses, but it is not a common withdrawal symptom. Withdrawal symptoms are more likely to include physical signs of cortisol deficiency rather than severe psychiatric symptoms.