A client has been on daily, high-dose prednisone therapy to treat an exacerbation of rheumatoid arthritis. His prescription runs out before his next paycheck. He decides to skip his prednisone for a few days. What is likely to happen to this patient when he abruptly stops taking prednisone?

A. Cushing syndrome is characterized by excessive levels of cortisol in the body, often due to an adrenal gland tumor or prolonged use of corticosteroid medications. The primary symptoms include weight gain, hypertension, and changes in skin appearance. Exophthalmos is not typically associated with Cushing syndrome.
B. Hashimoto's disease is an autoimmune thyroid disorder that leads to hypothyroidism (underactive thyroid). The condition is characterized by symptoms such as fatigue, weight gain, cold intolerance, and dry skin. Exophthalmos is not a feature of Hashimoto's disease. Instead, it is more commonly associated with hyperthyroidism.
C. Addison's disease is a condition caused by inadequate production of cortisol and aldosterone by the adrenal glands. Symptoms include fatigue, weight loss, hyperpigmentation of the skin, and low blood pressure. Exophthalmos is not related to Addison's disease.
D. Graves' disease is an autoimmune hyperthyroid condition that leads to an overproduction of thyroid hormones. One of the hallmark symptoms of Graves' disease is exophthalmos or protruding eyes, caused by inflammation and swelling of the tissues around the eyes. This condition is directly associated with exophthalmos.

A. Total bedrest is generally not recommended. It is important to balance rest with gentle movement to maintain joint function and prevent stiffness. Instead of complete bedrest, promoting periods of rest

while allowing for limited activity as tolerated is more appropriate. Avoiding use of affected joints may be beneficial during acute inflammation but complete immobilization can lead to muscle atrophy and joint stiffness.
B. Applying warm compresses to affected joints can help relieve stiffness and pain associated with RA. Warmth can improve blood flow and reduce muscle tension around the joints. This intervention is typically beneficial during periods of stiffness and can help increase comfort. However, cold compresses may also be used during acute inflammation to reduce swelling.
C. Placing pillows to keep the neck in a flexed position is not advisable for RA patients. It can cause discomfort and potentially worsen joint and muscle issues. Proper positioning should support natural body alignment, and patients should be encouraged to maintain a neutral neck position to avoid additional strain.
D. Continuous cardiac monitoring is not a routine intervention for RA exacerbations unless there is an indication of cardiac involvement or complications. RA itself does not typically require continuous cardiac monitoring.
E. Methylprednisolone is a corticosteroid used to reduce inflammation and manage RA symptoms during flares. Administering it as ordered is an appropriate intervention to control inflammation and alleviate symptoms.