A nurse is caring for a client who has Addison’s disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?
Weigh the client daily.
Restrict food intake.
Administer oral corticosteroids.
Provide a low carbohydrate diet.
The Correct Answer is C
Choice A Reason:
Weigh the client daily: While monitoring weight is important for clients with Addison’s disease, it is not the primary action to prevent an Addisonian crisis. Daily weight monitoring helps track fluid balance and detect any sudden changes that might indicate complications, but it does not directly address the hormonal imbalance that characterizes Addisonian crisis.
Choice B Reason:
Restrict food intake: Restricting food intake is not recommended for clients with Addison’s disease. Proper nutrition is crucial for maintaining energy levels and overall health. Clients with Addison’s disease need a balanced diet to manage their condition effectively. Restricting food intake could lead to malnutrition and exacerbate symptoms.
Choice C Reason:
Administer oral corticosteroids: This is the correct action. Addison’s disease is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Administering oral corticosteroids helps replace the deficient hormones and manage the symptoms of Addison’s disease. During an Addisonian crisis, immediate administration of corticosteroids is critical to prevent severe complications such as shock, coma, or even death.
Choice D Reason:
Provide a low carbohydrate diet: A low carbohydrate diet is not specifically recommended for clients with Addison’s disease. Instead, a balanced diet that includes adequate carbohydrates, proteins, and fats is essential. Carbohydrates are important for maintaining energy levels, especially since clients with Addison’s disease may experience fatigue and weakness. Restricting carbohydrates could lead to low blood sugar levels, which can be dangerous for these clients.
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Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Nonfat milk is generally considered safe for individuals with GERD. While full-fat dairy products can exacerbate GERD symptoms due to their high-fat content, nonfat milk does not have this effect. It is low in fat and unlikely to trigger acid reflux. Therefore, nonfat milk is not a food that needs to be avoided by someone with GERD.
Choice B Reason:
Apples are typically safe for individuals with GERD. In fact, non-citrus fruits like apples are often recommended as part of a GERD-friendly diet. They are low in acid and unlikely to cause reflux symptoms. Therefore, apples do not need to be avoided by someone with GERD.
Choice C Reason:
Chocolate is a common trigger for GERD symptoms. It contains caffeine and theobromine, both of which can relax the lower esophageal sphincter (LES), allowing stomach acid to escape into the esophagus and cause reflux. Additionally, chocolate is high in fat, which can further exacerbate GERD symptoms. Therefore, it is advisable for individuals with GERD to avoid chocolate to prevent worsening of their symptoms.
Correct Answer is D
Explanation
Choice A Reason:
Low oxygen saturation is not a common side effect of donepezil. Donepezil is a cholinesterase inhibitor used to treat symptoms of Alzheimer’s disease by increasing the levels of acetylcholine in the brain. While it can have various side effects, respiratory issues like low oxygen saturation are not typically associated with this medication. Therefore, monitoring for low oxygen saturation is not a primary concern for patients starting donepezil.
Choice B Reason:
High blood pressure is also not a common side effect of donepezil. The medication primarily affects the central nervous system and does not typically cause significant changes in blood pressure. While it is always important to monitor a patient’s overall health, high blood pressure is not a side effect specifically linked to donepezil use. Therefore, it is not a primary focus for monitoring in this context.
Choice C Reason:
Elevated body temperature is not commonly associated with donepezil. The side effects of donepezil are more likely to involve gastrointestinal issues such as nausea, vomiting, and diarrhea, as well as muscle cramps and fatigue. Elevated body temperature is not a typical reaction to this medication, so it is not a primary concern for monitoring.
Choice D Reason:
Low pulse rate, or bradycardia, is a known side effect of donepezil. Donepezil can increase the levels of acetylcholine, which can affect the heart’s electrical conduction system and lead to a slower heart rate. This can be particularly concerning in elderly patients or those with pre-existing heart conditions. Therefore, it is crucial for the nurse to teach the family to monitor the client’s pulse rate regularly and report any significant decreases to the healthcare provider.
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