A nurse is educating a client with systemic lupus erythematosus about the use of prednisone. Which piece of information should be prioritized?
Prednisone should never be discontinued abruptly.
Long-term effects of prednisone include redistribution of fat.
Prednisone can lead to sodium and fluid retention.
Prednisone might cause the client to feel jittery or nervous.
The Correct Answer is A
Choice A rationale:
Prednisone is a corticosteroid that suppresses the body's natural production of cortisol. Cortisol is a hormone that is essential for life, and it plays a role in many important bodily functions, including:
Regulating blood sugar levels Maintaining blood pressure Reducing inflammation Responding to stress
When a person takes prednisone for a long period of time, their body begins to rely on the medication to provide cortisol. If the medication is stopped suddenly, the body cannot produce enough cortisol on its own, which can lead to a life-threatening condition called adrenal insufficiency.
Adrenal insufficiency can cause a variety of symptoms, including: Extreme fatigue
Weakness Dizziness Nausea Vomiting Abdominal pain Confusion
Loss of consciousness
To prevent adrenal insufficiency, it is important to taper off prednisone slowly over a period of time. This allows the body to gradually adjust to producing cortisol on its own.
Here are some additional details about why prednisone should never be discontinued abruptly: The risk of adrenal insufficiency is highest when prednisone has been taken for more than 3 weeks. The longer a person has been taking prednisone, the slower the taper should be.
It is important to follow the tapering instructions provided by the healthcare provider.
If a person experiences any symptoms of adrenal insufficiency, they should seek medical attention immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Massaging the site with scented oils is not recommended for pain relief after removal of a peripheral vascular access device. There is no evidence to support the effectiveness of scented oils in this context.
Additionally, some scented oils can be irritating to the skin, which could potentially worsen the pain, redness, and swelling.
It's crucial to use products that are specifically designed for wound care and pain management, and to follow the healthcare provider's instructions.
Choice B rationale:
Applying warm compresses to the site is an effective and recommended intervention to alleviate pain, redness, and swelling after removal of a peripheral vascular access device.
Warm compresses have the following beneficial effects:
Vasodilation: They promote blood flow to the area, which helps to reduce inflammation and pain. Muscle relaxation: The warmth helps to relax tense muscles, further easing discomfort.
Pain relief: Warmth can directly inhibit pain signals, providing a soothing sensation.
Increased circulation: Improved blood flow can help to remove inflammatory substances and promote healing. It's important to use a clean, warm compress and to apply it for 15-20 minutes at a time, several times a day.
Choice C rationale:
Topical lidocaine is a local anesthetic that can temporarily numb the skin.
While it can be used for pain relief, it's not typically the first-line intervention for pain associated with removal of a peripheral vascular access device.
Warm compresses are often preferred as they provide a more natural and non-invasive approach to pain management.
Choice D rationale:
Oral pain medication may be necessary if warm compresses do not provide adequate pain relief.
However, it's important to follow the healthcare provider's instructions regarding the type and dosage of pain medication to use.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be sufficient in some cases. Stronger prescription pain medication may be needed for more severe pain.
Correct Answer is C
Explanation
Choice A rationale:
Uncompensated Respiratory Acidosis is characterized by a low pH (less than 7.35) and a high pCO2 (greater than 45 mmHg). In this case, the pH is slightly elevated (7.46), making this option less likely.
While the pCO2 is elevated (46 mmHg), the body has begun to compensate, as evidenced by the elevated HCO3 (29 mEq/L). This partial compensation does not align with an uncompensated respiratory acidosis.
Choice B rationale:
Compensated Metabolic Acidosis would present with a normal pH (7.35-7.45) due to full compensation by the respiratory system. In this case, the pH is slightly elevated (7.46), which is not consistent with full compensation.
Additionally, the HCO3 is elevated (29 mEq/L), which is characteristic of metabolic alkalosis, not acidosis.
Choice C rationale:
Partially Compensated Metabolic Alkalosis is the most likely interpretation based on the ABG results. The pH is elevated (7.46), indicating alkalosis.
The HCO3 is also elevated (29 mEq/L), which is the primary cause of metabolic alkalosis.
The pCO2 is elevated (46 mmHg), which is a compensatory mechanism to try to normalize the pH. However, the compensation is not complete, as the pH is still slightly elevated.
This partial compensation is consistent with partially compensated metabolic alkalosis.
Choice D rationale:
Partially Compensated Respiratory Acidosis would present with a low pH (less than 7.35) and an elevated pCO2 (greater than 45 mmHg).
The HCO3 would also be elevated, but to a lesser degree than in metabolic alkalosis, as it's a secondary compensatory mechanism.
In this case, the pH is slightly elevated (7.46), making respiratory acidosis less likely.
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