A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
Rebound pulmonary congestion
Hyperglycemia
Adrenocortical insufficiency
Severe dehydration
The Correct Answer is C
Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis.
Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency.
Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
When using an albuterol inhaler, it is important for the client to take a slow and deep inhalation while releasing the medication from the inhaler. After inhaling the medication, holding the breath for about 10 seconds allows the medication to reach deep into the airways and maximize its effectiveness.
The other actions mentioned are not correct:
A. Waiting 10 minutes between inhalations: Albuterol inhalers are typically used as a quick-relief medication for acute symptoms, and waiting 10 minutes between inhalations may not provide immediate relief when needed. The specific instructions on the frequency of inhalations should be provided by the healthcare provider.
B. Taking a quick inhalation while releasing the medication from the inhaler: It is important to take a slow and deep inhalation while releasing the medication to ensure that the medication reaches the lungs effectively. Taking a quick inhalation may result in less effective delivery of the medication.
D. Exhaling as the medication is released from the inhaler: It is important to exhale fully before using the inhaler to ensure that the medication is inhaled deeply into the lungs. Exhaling while releasing the medication can interfere with the proper inhalation technique.
Correct Answer is ["A","C","D"]
Explanation
The nurse must consider the following when obtaining a health history for a client with diabetes mellitus who has been taking glucocorticoids (prednisone) long-term for uncontrolled COPD:
- Due to the use of long-term glucocorticoids, the medication must not be abruptly discontinued to avoid adrenal suppression. Abruptly stopping glucocorticoids can lead to adrenal insufficiency and a potentially life-threatening condition. Gradual tapering of the medication is necessary under medical supervision.
- The use of long-term glucocorticoids may contribute to a spike in blood glucose levels. Glucocorticoids can cause insulin resistance and increase blood sugar levels, which can be problematic for individuals with diabetes mellitus.
- The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection. Glucocorticoids can suppress the immune system, making the client more susceptible to infections. This is important to consider, especially in a hospital setting where the risk of acquiring infections may be higher.
Regarding the other options:
The client may develop low blood pressure: While glucocorticoids can cause fluid retention and increased blood pressure, they are not typically associated with low blood pressure.
The client will most likely experience more pain: The use of glucocorticoids is not directly related to increased pain perception. Pain management may be influenced by various factors, but it is not specifically attributed to long-term glucocorticoid use.
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