A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) and is diagnosed with pneumonia. The client has been on a long-term regimen of methylprednisolone. Which precautions should the nurse take to prevent complications? Select all that apply.

Ensure the client receives adequate amounts of fluids: This is important to maintain hydration and thin respiratory secretions, making it easier for the client to cough and clear the airways. Check the client's mouth for stomatitis: Methylprednisolone can increase the risk of developing oral candidiasis (thrush) or stomatitis, which can cause discomfort and interfere with oral intake. Regular mouth checks can help identify these conditions early for appropriate management. Assess the client's mental status: Pneumonia, particularly in individuals with pre-existing lung disease like COPD, can lead to hypoxemia, which may affect mental status. It is important to monitor the client's mental status, as changes in cognition or confusion can be indicators of hypoxia and require prompt intervention.

Monitor for signs of hypokalemia: Methylprednisolone, like other corticosteroids, can cause electrolyte imbalances, including hypokalemia (low potassium levels). Hypokalemia can have various effects on the body, including muscle weakness and cardiac dysrhythmias. Regular monitoring of potassium levels and signs of hypokalemia is important for timely management. Monitor the client's blood glucose levels: Methylprednisolone can increase blood glucose levels, particularly in individuals with pre-existing diabetes or impaired glucose tolerance. Regular monitoring of blood glucose levels is necessary to ensure proper glycemic control and prevent hyperglycemia-related complications.

Monitor the client's blood pressure for hypotension: Corticosteroids like methylprednisolone can cause fluid retention, leading to an increase in blood pressure. However, sudden withdrawal of corticosteroids can result in adrenal insufficiency and hypotension. Close monitoring of blood pressure is necessary to identify any significant changes and adjust the medication regimen accordingly.

Effective teaching for a patient with peptic ulcer disease focuses on promoting understanding and adherence to the treatment plan, as well as addressing lifestyle modifications that can help manage the condition. Stress reduction is an important aspect of ulcer management, as stress

can exacerbate symptoms and delay healing. If the patient acknowledges learning relaxation strategies that decrease their stress, it indicates that they have grasped the concept and are likely to implement it in their daily life.

It is crucial for the patient to understand that any potential side effects should be reported to the healthcare provider, who will then determine the appropriate course of action. Abruptly stopping medications without medical guidance can have adverse consequences. While pain relief is an important goal, the treatment for peptic ulcer disease typically involves addressing the underlying cause, such as Helicobacter pylori infection or reducing stomach acid production. The patient should follow the treatment regimen as prescribed by the healthcare provider, even if they experience pain relief, to ensure proper healing and prevent ulcer recurrence.

Different antacids have different formulations and ingredients, and they may vary in terms of effectiveness and duration of action. It is important for the patient to consult with their healthcare provider or pharmacist to determine which antacid is most suitable for their specific needs.