A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)
Assess for neck vein distention
Monitor for postural hypotension
Assess blood glucose level
Monitor for an irregular heart rate
Weigh the client daily
Correct Answer : A,C,D,E
A. Assess for neck vein distention: Neck vein distention can occur in Cushing's syndrome due to fluid retention and hypertension. It is an important sign to monitor as it can indicate complications like heart failure.
B. Monitor for postural hypotension: Clients with Cushing's syndrome typically have hypertension rather than hypotension. Therefore, postural hypotension is not a common issue to monitor for in these patients.
C. Assess blood glucose level: Hyperglycemia is common in Cushing's syndrome due to increased cortisol levels, which promote glucose production and reduce glucose uptake by cells. Monitoring blood glucose is essential to manage this condition.
D. Monitor for an irregular heart rate: Cushing's syndrome can cause electrolyte imbalances (like hypokalemia), which may lead to cardiac arrhythmias, so monitoring for an irregular heart rate is important.
E. Weigh the client daily: Daily weight monitoring helps track fluid retention, which is common in Cushing's syndrome due to cortisol-induced fluid retention. This can help in managing the client’s fluid status and detecting worsening of symptoms.
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Related Questions
Correct Answer is B
Explanation
A. Notify the provider of a weight gain of 0.5 kg (1 lb) in a week: A weight gain of 0.5 kg (1 lb) in a week can indicate fluid retention and worsening heart failure. Clients should be instructed to report such changes promptly to their healthcare provider to adjust treatment and prevent complications.
B. Exercise at least three times per week: Regular exercise is important for maintaining overall health and improving heart function. However, it is generally recommended to consult a healthcare provider to tailor an exercise regimen suitable for the client's condition.
C. Take diuretics early in the morning and before bedtime: Diuretics should typically be taken in the morning to avoid nocturia (frequent nighttime urination) and disruption of sleep. Taking them before bedtime is not advised due to the increased risk of sleep disturbance.
D. Take naproxen for generalized discomfort.: NSAIDs like naproxen are generally not recommended for clients with heart failure because they can cause sodium and fluid retention, potentially worsening heart failure symptoms.
Correct Answer is C
Explanation
A. Pitting edema: Pitting edema is more indicative of fluid retention, often associated with heart failure itself, rather than a direct sign of hypokalemia.
B. Dyspnea: Dyspnea is typically a symptom of fluid overload or respiratory conditions and is not a specific indicator of hypokalemia.
C. Fatigue: Fatigue is a common symptom of hypokalemia because low potassium levels affect muscle function and overall energy levels. It is a key indicator of electrolyte imbalance.
D. Oliguria: Oliguria, or decreased urine output, is more associated with kidney function issues or severe dehydration, not directly with hypokalemia.
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