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
Rebound congestion, also known as rhinitis medicamentosa, is a common adverse effect associated with the prolonged use of nasal decongestants. It occurs when the blood vessels in the nasal passages become dependent on the medication for constriction and lose their ability to regulate naturally. As a result, when the medication wears off, the nasal congestion worsens, leading to a cycle of continued use and worsening symptoms.
In this scenario, the patient's complaint of worsening nasal congestion despite using oxymetazoline every 2 to 4 hours for the past 5 days suggests the possibility of rebound congestion. The nurse should explain to the patient that prolonged or frequent use of nasal decongestants can lead to this effect and recommend gradually tapering off the medication use or discontinuing it altogether. The nurse may also suggest alternative non-medication strategies for managing nasal congestion, such as saline nasal sprays or steam inhalation.
Correct Answer is A
Explanation
Expectorants are medications that help thin and loosen mucus in the respiratory tract, making it easier to cough up and clear from the airways. Increasing fluid intake, particularly water helps to keep the mucus thin and less sticky, facilitating its removal. Adequate hydration can help promote effective expectoration and relieve congestion.
The other options are incorrect because:
B. Taking the medication once a day only, usually at bedtime: The dosing frequency and timing of expectorants can vary depending on the specific medication prescribed. It is important to follow the healthcare provider's instructions regarding the dosing schedule.
C. Increase fiber and fluid intake to prevent constipation: This instruction is unrelated to expectorant use. Increasing fiber and fluid intake is commonly recommended to promote regular bowel movements and prevent constipation, but it is not directly related to expectorant therapy.
D. Restrict fluids to decrease mucus production: Restricting fluids can lead to dehydration and thickening of mucus secretions. It is important to stay adequately hydrated to maintain thin and easily expectorated mucus. Restricting fluids is not recommended for managing mucus production.
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