A client with diabetes mellitus is being admitted to the hospital for surgery. The client has been taking Glucocorticoids (Prednisone) long-term for uncontrolled COPD. Which of the following must the nurse consider when she is obtaining a health history? (Select All that Apply.)
Due to the use of long-term glucocorticoids her medication must not be abruptly discontinued to avoid adrenal suppression
The client may develop low blood pressure
The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection
The use of long-term glucocorticoids may have contributed to a spike in blood glucose levels
The client will most likely experience more pain
Correct Answer : A,C,D
The nurse must consider the following when obtaining a health history for a client with diabetes mellitus who has been taking glucocorticoids (prednisone) long-term for uncontrolled COPD:
- Due to the use of long-term glucocorticoids, the medication must not be abruptly discontinued to avoid adrenal suppression. Abruptly stopping glucocorticoids can lead to adrenal insufficiency and a potentially life-threatening condition. Gradual tapering of the medication is necessary under medical supervision.
- The use of long-term glucocorticoids may contribute to a spike in blood glucose levels. Glucocorticoids can cause insulin resistance and increase blood sugar levels, which can be problematic for individuals with diabetes mellitus.
- The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection. Glucocorticoids can suppress the immune system, making the client more susceptible to infections. This is important to consider, especially in a hospital setting where the risk of acquiring infections may be higher.
Regarding the other options:
The client may develop low blood pressure: While glucocorticoids can cause fluid retention and increased blood pressure, they are not typically associated with low blood pressure.
The client will most likely experience more pain: The use of glucocorticoids is not directly related to increased pain perception. Pain management may be influenced by various factors, but it is not specifically attributed to long-term glucocorticoid use.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Benzonatate is available in capsule form (such as Tessalon Pearls), and it should be swallowed whole. It is important not to chew, crush, or break the capsules as this can cause adverse effects, including local anesthesia in the oral cavity, which can lead to choking or difficulty swallowing. Swallowing the capsule whole ensures that the medication is released properly in the stomach for the desired effect.
The other options mentioned are incorrect:
A. Eating a high-fat meal prior to taking medication: There is no specific requirement to eat a high-fat meal before taking Benzonatate. However, taking it with food or a glass of water may help with ease of swallowing.
B. Taking medication often and whenever a cough is starting: Benzonatate should be taken as directed by the healthcare provider. It is not recommended to take it more frequently or as needed, as it can lead to an overdose or unwanted side effects.
D. Taking medication with orange juice: There is no specific requirement to take Benzonatate with orange juice. It can be taken with water or other non-alcoholic beverages as directed by the healthcare provider.
Correct Answer is B
Explanation
A. Administering the granules mixed with 20 oz of water is not necessary. Montelukast granules can be administered directly into the mouth or mixed with a small amount of soft food (e.g., applesauce) if necessary. The specific instructions for administration should be provided by the healthcare provider or included in the product labeling.
B.If you’re using it to prevent breathing problems related to exercise, take a single dose at least 2 hours before exercising. However, another dose cannot be taken within 24 hours.
C.Montelukast is a leukotriene receptor antagonist commonly used for the maintenance treatment of asthma in children and adults. The usual recommended dose is once daily in the evening, depending on the specific instructions from the healthcare provider.
D. Administering the medication at the onset of wheezing is not the recommended approach. Montelukast is a daily maintenance medication for asthma and should be taken regularly as prescribed, regardless of wheezing symptoms. It is not intended to be used for immediate relief of wheezing or acute asthma symptoms. Short-acting bronchodilators are typically used for quick relief of wheezing or acute asthma symptoms.
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