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
During an asthma attack, the primary concern is the patient's ability to breathe and maintain adequate oxygenation. Monitoring the patient's respiratory rate and oxygen saturation (SpO2) with a pulse oximeter provides crucial information about the effectiveness of the albuterol treatment and the patient's respiratory status. It helps determine if the airway is opening up, if oxygen levels are improving, and if the patient is responding positively to the medication.
While determining the time of the patient's last meal can be relevant for certain interventions, it is not the immediate priority during an asthma attack. It is more important to focus on assessing and managing the patient's breathing and oxygenation first.
Monitoring the patient's temperature and blood pressure can be important for a comprehensive assessment, but they are not the immediate priority during an acute asthma attack. Addressing the patient's respiratory distress takes precedence.
Providing education on asthma management and treatment is an important aspect of care, but it should be done after the patient's acute symptoms are addressed and stabilized. In the immediate assessment phase, the focus is on assessing and managing the patient's respiratory status. Education can be provided once the patient's immediate needs are addressed.
Correct Answer is A
Explanation
Nasal glucocorticoids are commonly used to treat allergic rhinitis and work by reducing inflammation in the nasal passages. However, one of the potential side effects of using these medications is the drying of the nasal mucosa, which can lead to discomfort and occasional nosebleeds. It is important for clients to be aware of this side effect and to take appropriate measures to mitigate it, such as using a humidifier, staying hydrated, and gently applying a saline nasal spray if needed.
Rhinorrhea refers to a runny nose and is not a common side effect of fluticasone or other nasal glucocorticoids. Dizziness and hallucinations are also not typical side effects associated with the use of fluticasone. However, it is important to note that individual responses to medications can vary, and if a client experiences any unusual or concerning side effects while taking fluticasone, they should consult their healthcare provider for further evaluation.
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