A nurse in a clinic is reviewing the home medications of client who has a history of asthma, and who is at the clinic to have a routine annual physical. Which statement made by the patient would indicate a need for further action by the nurse?

A. Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B. Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C. Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D. Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E. Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.

A. The immediate concern with abrupt cessation is more related to adrenal insufficiency rather than hyperglycemia. However, chronic use of prednisone can contribute to glucose intolerance and diabetes, but this is not the primary issue with sudden discontinuation.
B. Abrupt discontinuation of prednisone can lead to adrenal insufficiency because the body has become reliant on the medication to suppress inflammation and regulate various bodily functions. The adrenal glands may not immediately resume normal cortisol production, which can lead to symptoms of adrenal insufficiency, including hypotension.

C. Fluid retention is a common side effect of prednisone use. However, stopping prednisone suddenly does not typically cause fluid retention; rather, it can lead to other issues like adrenal insufficiency. Fluid retention is more related to the medication's use rather than its abrupt discontinuation.
D. Abruptly stopping high-dose prednisone, especially after long-term use, can be dangerous. The body may not immediately resume normal cortisol production, leading to symptoms of adrenal insufficiency, such as fatigue, weakness, and hypotension. It is crucial to taper off prednisone gradually under medical supervision to allow the adrenal glands time to recover and to avoid withdrawal symptoms.