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?

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.

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:

1. 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.
2. 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.
3. 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.