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 B
Explanation
Codeine is an opioid medication that can cause drowsiness and dizziness. Changing positions quickly, especially from lying down to standing up, can increase the risk of falls or accidents.
Instructing the client to change positions slowly helps prevent orthostatic hypotension (a drop in blood pressure upon standing) and reduces the risk of falls.
The other options listed are not appropriate instructions for a client taking codeine:
A. "You should expect to experience diarrhea while taking this medication." While constipation is a common side effect of opioids, diarrhea is not typically associated with codeine use. Therefore, there is no need to expect or warn about diarrhea as an anticipated effect of taking codeine.
C. "You should limit alcohol intake to 12 ounces daily." Mixing alcohol with codeine can have harmful effects, such as increased sedation and respiratory depression. However, it is generally recommended to avoid alcohol completely while taking codeine, rather than setting a specific limit of 12 ounces daily.
D. "You should take the medication on an empty stomach to prevent nausea." Taking codeine with or without food can vary depending on individual factors and the specific instructions provided by the healthcare provider. However, taking codeine on an empty stomach does not necessarily prevent nausea. In fact, taking it with food may help reduce stomach upset for some individuals. It is best to follow the specific instructions provided by the healthcare provider regarding the timing of codeine administration with or without food.
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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