A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?
Hyperkalemia
Hypokalemia
Hypermagnesemia
Hypomagnesemia
The Correct Answer is B
Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.
Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.
Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.
Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:This is incorrect. When mixing regular (clear) and NPH (cloudy) insulin, air should be injected into the NPH vial first, then into the regular insulin vial. This prevents contamination of the regular insulin with NPH insulin.
Choice B reason: This is incorrect because the nurse should not shake the NPH insulin vial, but rather roll it gently between the palms to mix it. Shaking can cause bubbles and affect the accuracy of the dose.
Choice C reason: This is incorrect because the nurse should draw up the regular insulin into the syringe first, then the NPH insulin. This prevents mixing of the NPH insulin with the regular insulin in the vial.
Choice D reason: This is correct. Regular insulin should always be clear. If it appears cloudy, it may be contaminated or expired and should be discarded.
Correct Answer is B
Explanation
Choice A reason: Antibiotics are not likely to interact with corticosteroids, unless they are aminoglycosides, which can increase the risk of hypokalemia. However, most antibiotics do not affect the metabolism or efficacy of corticosteroids.
Choice B reason: Nonsteroidal anti-inflammatory drugs (NSAIDs) can interact with corticosteroids, as they both have anti-inflammatory and immunosuppressive effects. This can increase the risk of gastrointestinal bleeding, ulceration, and perforation. Therefore, the nurse should monitor the patient for signs of bleeding and advise the patient to avoid taking NSAIDs with corticosteroids.
Choice C reason: Opioid analgesics are not likely to interact with corticosteroids, unless they are codeine, which can decrease the clearance of corticosteroids. However, most opioid analgesics do not affect the metabolism or efficacy of corticosteroids.
Choice D reason: Antidepressants are not likely to interact with corticosteroids, unless they are monoamine oxidase inhibitors (MAOIs), which can increase the risk of hypertension and hypertensive crisis. However, most antidepressants do not affect the metabolism or efficacy of corticosteroids.
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