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.)

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:

1. 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.
2. 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.
3. 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.

Nasal glucocorticoids, also known as intranasal corticosteroids, are considered the most effective and recommended first-line treatment for nasal congestion caused by allergic rhinitis or non-allergic rhinitis. They work by reducing inflammation in the nasal passages, relieving congestion, and improving other symptoms such as itching, sneezing, and runny nose.

Leukotriene modifiers, decongestants, and antihistamines can also be used to manage nasal congestion, but they are generally considered second-line options or adjunct therapies.

Decongestants provide temporary relief by constricting blood vessels in the nasal passages, while antihistamines help with symptoms related to allergies. Leukotriene modifiers are primarily used for managing asthma and are not typically the first choice for nasal congestion alone.