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.

Answer and Explanation

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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Correct Answer is B

Explanation

Choice A: You May Bring Some Music to Listen to for Distraction

Bringing music for distraction is generally not a standard instruction given before an EEG. While listening to music might help some patients relax, it is not a critical part of the preparation for the test. The primary focus of EEG preparation is to ensure accurate readings of brain activity, which can be influenced by various factors such as medication and sleep.

Choice B: Do Not Take Any Sedatives 12 to 24 Hours Before the Test

Avoiding sedatives before an EEG is crucial because these medications can alter brain activity and affect the test results. Sedatives can suppress the electrical activity in the brain, leading to inaccurate readings. Therefore, it is essential for patients to avoid taking any sedatives 12 to 24 hours before the test to ensure the EEG captures the brain’s natural activity.

Choice C: You Will Need to Have Someone to Drive You Home

This instruction is typically given if the patient is expected to be sedated or if the test involves procedures that might impair their ability to drive. However, for a standard EEG, patients are usually not sedated, and there is no need for someone to drive them home. This instruction is more relevant for other types of medical procedures that involve sedation.

Choice D: Please Do Not Have Anything to Eat or Drink After Midnight

Fasting is not a standard requirement for an EEG. Patients are generally allowed to eat and drink before the test. However, they are often advised to avoid caffeine as it can affect brain activity. The instruction to avoid food and drink after midnight is more commonly associated with procedures that require anesthesia or sedation, not an EEG.

A. Rosebud-like stoma orifice B. Stoma oozing red drainage C. Shiny, moist stoma D. Purplish-colored stoma

Correct Answer is D

Explanation

Choice A Reason:

A rosebud-like stoma orifice is a normal finding for a newly created colostomy. This appearance indicates that the stoma is healthy and well-formed. The stoma should protrude slightly from the abdomen and have a pink or red color, similar to the inside of the mouth. This indicates good blood flow and proper healing. Therefore, a rosebud-like stoma orifice does not need to be reported to the provider.

Choice B Reason:

A stoma oozing red drainage can be concerning, but it is not uncommon for a new stoma to have some minor bleeding or oozing, especially in the immediate postoperative period. This can occur due to the delicate nature of the tissue and the recent surgical intervention. However, if the drainage is excessive or persistent, it should be monitored closely and reported if it does not improve. Minor oozing is generally expected and does not necessarily indicate a serious problem.

Choice C Reason:

A shiny, moist stoma is a normal finding and indicates that the stoma is healthy. The stoma should be moist and have a shiny appearance, similar to the inside of the mouth. This moisture is necessary for the proper function and health of the stoma. Therefore, a shiny, moist stoma does not need to be reported to the provider.

Choice D Reason:

A purplish-colored stoma is an abnormal finding and should be reported to the provider immediately. This discoloration can indicate compromised blood flow to the stoma, which can lead to tissue necrosis if not addressed promptly. A healthy stoma should be pink or red, indicating good blood circulation. Any deviation from this color, especially a purplish or dark color, is a sign of potential ischemia or other serious complications that require immediate medical attention.

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