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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Related Questions
Correct Answer is C
Explanation
Acetaminophen is generally considered safe and well-tolerated when used appropriately. However, it is primarily metabolized by the liver, and in cases of severe hepatic impairment or liver failure, the metabolism of acetaminophen can be significantly impaired. This can lead to the accumulation of toxic metabolites, which can cause further liver damage and potentially result in hepatotoxicity.
Hypertension, gallbladder disease, and tachyarrhythmias are not typically considered contraindications for the use of acetaminophen. However, it is important to consider any potential interactions or precautions when using acetaminophen in patients with these conditions, and consulting with a healthcare provider is recommended to ensure the safe and appropriate use of the medication.
Correct Answer is A
Explanation
Inhaled fluticasone (Flovent) is a corticosteroid medication that is commonly used in the treatment of asthma. It works by reducing inflammation in the airway, which is a key component of asthma. By decreasing inflammation, it helps to prevent and control asthma symptoms, such as wheezing, coughing, and shortness of breath.
The other options mentioned are incorrect:
B. Relieves symptoms of an acute asthma attack: Inhaled fluticasone is not intended for immediate relief during an acute asthma attack. It is a long-term control medication used to manage and prevent asthma symptoms.
C. Causes immediate bronchodilation: Fluticasone does not cause immediate bronchodilation, which refers to the widening of the airways to improve breathing. Bronchodilation is typically achieved with short-acting beta-agonist medications, such as albuterol.
D. Reduces blood pressure and heart rate: Fluticasone is not known to have a direct effect on blood pressure or heart rate. Its primary action is to reduce inflammation in the airway for the management of asthma.
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