Which safety measure is most important for the nurse to institute for a patient who has Cushing Syndrome?

Using a lift sheet to change the patient's position

Assisting the patient to change positions slowly

Padding the siderails of the patient's bed

Keeping suctioning equipment at the patient's bedside

Answer and Explanation

The Correct Answer is B

A. Using a lift sheet is helpful for preventing injury and ensuring safe handling of the patient, but it is not the most critical safety measure for a patient with Cushing’s syndrome.
B. Assisting the patient to change positions slowly is the most important safety measure for a patient with Cushing’s syndrome. Patients with Cushing’s syndrome often have osteoporosis and a risk of fractures due to prolonged exposure to high cortisol levels, which can lead to weakened bones. Orthostatic hypotension may also occur, so changing positions slowly can prevent falls.
C. Padding the siderails of the bed is typically done for patients at risk of seizures or those with neurological issues, not as a primary concern for patients with Cushing’s syndrome.
D. While keeping suction equipment at the bedside is important for patients at risk of aspiration or respiratory issues, it is not the most critical measure for a patient with Cushing’s syndrome. The most significant concern is the risk of falls and fractures due to bone weakening and potential hypotension.

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Correct Answer is B

Explanation

A. Constant bubbling in the suction-control chamber is normal as it indicates that the suction is active and functioning as intended. The chamber should have steady bubbling when suction is applied.
B. Continuous bubbling in the water-seal chamber is abnormal and indicates a potential air leak. The water-seal chamber should only bubble intermittently with respiratory effort or changes in pressure; constant bubbling suggests that air is being introduced into the system, which could indicate a malfunction or an air leak at the insertion site or along the tubing.
C. Fluid-level fluctuations in the water-seal chamber are normal and should be observed, especially with breathing. The fluid levels will rise with inspiration and fall with expiration, reflecting the changes in pressure within the pleural space.
D. Bloody drainage in the collection chamber is expected immediately after surgery, particularly in the early postoperative period. It may be a sign of surgical site drainage, but if it becomes excessive or persists, further assessment is required. However, a small amount of blood in the collection chamber initially is not abnormal.

A. Monitor for postural hypotension B. Assess blood glucose level C. Monitor for an irregular heart rate D. Assess for neck vein distention E. Weigh the client daily

Correct Answer is ["B","D","E"]

Explanation

A. Monitor for postural hypotension: This is unlikely in Cushing’s syndrome, where hypertension (not hypotension) is more common due to excess cortisol and fluid retention.
B. Assess blood glucose level: Hyperglycemia is common in Cushing’s syndrome due to the effects of cortisol on glucose metabolism, so monitoring blood glucose levels is essential.
C. Monitor for an irregular heart rate: While Cushing's syndrome can lead to electrolyte imbalances that may affect heart rhythm, this is not a primary intervention in Cushing's syndrome. Monitoring for hypertension and fluid retention is more critical.
D. Assess for neck vein distention: Elevated cortisol levels can lead to fluid retention and hypertension, contributing to neck vein distention, so this is an important observation.
E. Weigh the client daily: Fluid retention and weight gain are key features of Cushing's syndrome, so daily weight monitoring helps assess fluid status and detect rapid weight gain indicative of worsening symptoms.

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Which safety measure is most important for the nurse to institute for a patient who has Cushing Syndrome?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 12 hr postoperative and has a chest tube to a disposable water-seal drainage system with suction. The nurse should intervene for which of the following observations?

Correct Answer is B

Explanation

A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

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