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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
The nurse should make the following responses regarding how albuterol helps the client's breathing:
- The medication will open the airways.
- The medication will prevent wheezing.
Albuterol is a bronchodilator medication commonly used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). It works by relaxing the smooth muscles in the airways, leading to the dilation of the bronchial tubes and increased airflow. This mechanism helps open up the airways and prevent or relieve symptoms such as wheezing, shortness of breath, and chest tightness.
The other options are incorrect because:
The medication will decrease coughing episodes: While albuterol may indirectly reduce coughing episodes by opening up the airways and improving airflow, its primary effect is on bronchodilation rather than directly targeting coughing.
The medication will stimulate the flow of mucus: Albuterol is not known to stimulate mucus flow. Instead, it focuses on bronchodilation to improve airflow in the lungs.
The medication will reduce inflammation: Albuterol is primarily a bronchodilator and does not have a significant anti-inflammatory effect. Other medications, such as corticosteroids, are typically used to address inflammation in respiratory conditions.
Correct Answer is C
Explanation
Status asthmaticus is a severe and potentially life-threatening asthma exacerbation that does not respond well to usual treatment measures. The primary goal in managing status asthmaticus is to relieve the bronchospasm and improve airflow. Short-acting 62-agonists, such as albuterol, are bronchodilators that work quickly to relax the smooth muscles of the airways, providing immediate relief of bronchospasm.
While determining the cause of the acute exacerbation and obtaining a peak flow reading are important aspects of asthma management, in the case of status asthmaticus, the immediate priority is to administer a bronchodilator to alleviate the severe symptoms and improve the child's breathing. Once the acute symptoms are addressed, further assessment and interventions can be carried out to identify the cause and monitor the child's condition.
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