A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

Hyperglycemia

Hyperkalemia

Fluid retention

Gl distress

Hypotension

Answer and Explanation

Correct Answer : A,C,D

A) Hyperglycemia:
Prednisone, a glucocorticoid, can increase blood glucose levels by stimulating the liver to produce more glucose and decreasing the effectiveness of insulin. This can lead to hyperglycemia, particularly in individuals who are predisposed to diabetes or glucose intolerance. Therefore, monitoring blood glucose levels is important during prednisone therapy, especially in clients with a history of diabetes or those at risk for developing it.

B) Hyperkalemia:
Prednisone and other corticosteroids typically decrease potassium levels rather than increase them. This occurs because corticosteroids can promote the excretion of potassium in the kidneys. Hyperkalemia is not a common side effect of prednisone therapy. In fact, hypokalemia (low potassium) is more likely to occur, so this is not a concern for clients receiving prednisone.

C) Fluid retention:
One of the common side effects of prednisone is fluid retention due to its effect on the kidneys and the way it can increase sodium reabsorption. This can lead to edema (swelling), especially in the lower extremities, and could also contribute to an increase in blood pressure. Clients taking prednisone, particularly in higher doses or for extended periods, should be monitored for signs of fluid retention and hypertension.

D) GI distress:
Gastrointestinal distress, including gastritis, ulcers, or nausea, is a common side effect of prednisone and other corticosteroids. The risk is higher if the medication is taken on an empty stomach or at high doses. To minimize this, prednisone is typically taken with food or milk, and clients are monitored for signs of GI irritation.

E) Hypotension:
Prednisone can cause increased blood pressure due to fluid retention and the resulting increased blood volume. It can also affect the balance of sodium and potassium, contributing to hypertension rather than hypotension. Hypotension is not a typical side effect of prednisone therapy, and the nurse should be vigilant for signs of high blood pressure rather than low.

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Correct Answer is D

Explanation

A. "Are you having any headaches?" : While headaches can be a side effect of medications, this question does not directly assess the effectiveness of baclofen. Baclofen is primarily used to reduce muscle spasms and improve muscle tone.

B. "How has your appetite been?": Changes in appetite can be related to many factors, including medication side effects, but this question does not address the primary purpose of baclofen, which is to manage muscle spasms.

C. "Does your urine look clear or cloudy?": The appearance of urine is not directly related to the effectiveness of baclofen. This question might be more relevant to assessing other conditions or medications that affect the urinary system.

D. "Are you having trouble with spasms?": Baclofen (Lioresal) is prescribed to manage and reduce muscle spasms in conditions like multiple sclerosis. Asking the client about their experience with muscle spasms directly assesses the effectiveness of the medication in managing their symptoms.

A. ‘’I have a legal obligation to report this type of abuse." B. "Let's get these treated, and I will maintain confidence." C. "Let's talk about ways to prevent someone from hitting you" D. "If this happens again, you must call the emergency department."

Correct Answer is A

Explanation

A) "I have a legal obligation to report this type of abuse."
The nurse has a legal and ethical obligation to report suspected abuse or neglect, especially in vulnerable populations such as older adults. In many jurisdictions, mandatory reporting laws require healthcare professionals to report suspected abuse to the appropriate authorities (e.g., Adult Protective Services, law enforcement) to ensure the safety of the client.

B) "Let's get these treated, and I will maintain confidence."
While it is essential to provide care for the physical injuries, the nurse cannot promise to maintain confidence in cases of suspected abuse. Confidentiality can be breached in situations where a legal obligation to report abuse exists. Failing to report suspected abuse could jeopardize the client's safety and place the nurse at risk of legal consequences.

C) "Let's talk about ways to prevent someone from hitting you."
This might seem compassionate, but it does not address the legal obligation to report the abuse. The priority should be to ensure the client's safety by reporting the situation to the appropriate authorities. Focusing on preventative measures without reporting the abuse first may imply that the responsibility lies with the client to prevent the abuse, rather than ensuring that the perpetrator is held accountable and the client is protected from harm.

D) "If this happens again, you must call the emergency department."
While advising the client to call the emergency department is a reasonable step in cases of immediate harm, it does not address the current abuse or the need for immediate intervention. The nurse's primary responsibility is to report the abuse to the proper authorities and ensure the client's safety.

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A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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