A nurse is providing discharge instructions to a client who has rheumatoid arthritis and a prescription for oral betamethasone. Which of the following statements should the nurse make about how to take this medication?

Choice A reason: A High Concentration of Carbon Monoxide Can Cause Death

This statement is correct. Carbon monoxide (CO) is a colorless, odorless, and tasteless gas that can be deadly at high concentrations. It binds to hemoglobin in the blood more effectively than oxygen, leading to hypoxia (lack of oxygen) in body tissues. High levels of CO can cause severe symptoms such as confusion, loss of consciousness, and death if not treated promptly.

Choice B reason: I Should Purchase a Carbon Monoxide Detector for My Home

This statement is also correct. Installing a carbon monoxide detector in the home is a crucial safety measure. These detectors can alert individuals to the presence of CO, allowing them to take action before the gas reaches dangerous levels. It is recommended to place detectors near sleeping areas and to test them regularly to ensure they are functioning properly.

Choice C reason: Breathing in Carbon Monoxide Can Cause Headaches and Nausea

This statement is accurate. Early symptoms of carbon monoxide poisoning include headaches, dizziness, nausea, and fatigue. These symptoms occur because CO interferes with the body’s ability to transport and use oxygen, leading to hypoxia. If exposure continues, symptoms can worsen and lead to more severe health issues.

Choice D reason: I Can Detect the Presence of Carbon Monoxide by a Metallic Odor

This statement indicates a need for further instruction. Carbon monoxide is odorless, which means it cannot be detected by smell. This is why CO is often referred to as a “silent killer.” Relying on the ability to smell CO is dangerous and ineffective. The only reliable way to detect CO is through the use of a carbon monoxide detector.

Choice A reason: Ulnar Deviation

Ulnar deviation, or the bending of the fingers towards the ulna (the outer bone of the forearm), is more commonly associated with rheumatoid arthritis rather than osteoarthritis. Rheumatoid arthritis typically affects the joints symmetrically and can lead to deformities such as ulnar deviation due to chronic inflammation.

Choice B reason: Symmetric Joints Affected

Symmetric joint involvement is characteristic of rheumatoid arthritis, not osteoarthritis. Osteoarthritis usually affects joints asymmetrically, meaning it can affect one joint more than the other. It commonly affects weight-bearing joints such as the knees, hips, and spine.

Choice C reason: Pain Worsens with Activity

Pain that worsens with activity is a hallmark symptom of osteoarthritis. This condition is caused by the breakdown of cartilage in the joints, leading to pain and stiffness, especially after physical activity. The pain typically improves with rest but can become more persistent as the disease progresses.

Choice D reason: Weight Loss

Weight loss is not a typical manifestation of osteoarthritis. In fact, being overweight or obese is a risk factor for developing osteoarthritis, particularly in weight-bearing joints. Weight management is often recommended to help reduce the stress on affected joints and alleviate symptoms.