A nurse is providing dietary teaching for a client who has Cushing’s disease. Which of the following recommendations should the nurse include in the teaching?
Decrease protein intake.
Restrict sodium intake.
Limit intake of potassium-rich foods.
Increase carbohydrate intake.
The Correct Answer is B
Choice A Reason:
Decrease protein intake: This is not typically recommended for clients with Cushing’s disease. Protein is essential for maintaining muscle mass and overall health. Clients with Cushing’s disease often experience muscle weakness and wasting, so adequate protein intake is crucial to help counteract these effects. Therefore, decreasing protein intake would not be beneficial.
Choice B Reason:
Restrict sodium intake: Clients with Cushing’s disease often suffer from hypertension (high blood pressure) due to the excess cortisol in their bodies. High sodium intake can exacerbate this condition by increasing blood pressure even further. Therefore, it is crucial to restrict sodium intake to help manage hypertension and reduce the risk of cardiovascular complications. Foods high in sodium include processed foods, canned soups, and salty snacks. The recommended daily sodium intake for most adults is less than 2,300 milligrams, but for those with hypertension, it is often advised to consume even less.
Choice C Reason:
Limit intake of potassium-rich foods: This is not a standard recommendation for clients with Cushing’s disease. In fact, potassium is often beneficial as it can help counteract the effects of sodium and lower blood pressure. Potassium-rich foods include bananas, oranges, spinach, and sweet potatoes. Limiting these foods would not be advantageous and could potentially worsen hypertension.
Choice D Reason:
Increase carbohydrate intake: Increasing carbohydrate intake is not typically recommended for clients with Cushing’s disease. Excess cortisol can lead to increased blood sugar levels and a higher risk of developing diabetes. Therefore, it is important to manage carbohydrate intake carefully to avoid spikes in blood sugar. Instead, a balanced diet with a focus on complex carbohydrates, lean proteins, and healthy fats is recommended.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Thirst is a common and expected symptom after an EGD, especially if the client has been fasting before the procedure. It does not typically indicate a complication and can be managed by gradually reintroducing fluids as tolerated. Therefore, thirst does not require further nursing assessment beyond routine post-procedure care.
Choice B Reason:
A sore throat is also a common symptom following an EGD. The procedure involves passing an endoscope through the throat, which can cause temporary irritation and discomfort. This symptom usually resolves on its own within a few days and does not indicate a serious complication. Therefore, a sore throat does not require further nursing assessment beyond providing comfort measures such as lozenges or warm saltwater gargles.
Choice C Reason:
Abdominal distention is a concerning symptom that requires further nursing assessment. It can indicate complications such as perforation, bleeding, or infection following the EGD. Perforation of the gastrointestinal tract is a rare but serious complication that can lead to peritonitis and sepsis if not promptly addressed. Therefore, any signs of abdominal distention should be reported to the provider immediately for further evaluation and intervention.
Choice D Reason:
Drowsiness is a common side effect of the sedatives used during the EGD procedure. It is expected that the client may feel drowsy or sleepy for a few hours after the procedure as the sedative wears off. This symptom does not typically require further nursing assessment unless it persists for an unusually long time or is accompanied by other concerning symptoms such as difficulty breathing or altered mental status.
Correct Answer is A
Explanation
Choice A Reason:
0.45% sodium chloride (half-normal saline) is an appropriate solution for treating hypernatremia, especially in a client who is NPO (nothing by mouth). This hypotonic solution helps to gradually reduce the serum sodium levels by providing free water to the extracellular space, which dilutes the high sodium concentration. It is essential to administer this solution slowly to avoid rapid shifts in fluid balance, which can lead to cerebral edema.
Choice B Reason:
Dextrose 5% in 0.9% sodium chloride (D5NS) is not the best choice for treating hypernatremia. While it provides some free water, the presence of 0.9% sodium chloride makes it an isotonic solution, which does not effectively lower serum sodium levels. This solution is more suitable for maintaining fluid balance rather than correcting hypernatremia.
Choice C Reason:
Lactated Ringer’s is also not appropriate for treating hypernatremia. This isotonic solution contains electrolytes, including sodium, which can exacerbate hypernatremia rather than correct it. Lactated Ringer’s is typically used for fluid resuscitation and electrolyte replacement in other clinical scenarios.
Choice D Reason:
Dextrose 10% in water (D10W) is a hypertonic solution and is not suitable for treating hypernatremia. While it provides free water, the high concentration of dextrose can lead to rapid shifts in fluid balance and potential complications such as hyperglycemia. This solution is generally used for providing calories and preventing hypoglycemia in specific clinical situations.
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