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A client with diabetes mellitus is being admitted to the hospital for surgery. The client has been taking Glucocorticoids (Prednisone) long-term for uncontrolled COPD. Which of the following must the nurse consider when she is obtaining a health history? (Select All that Apply.)

Due to the use of long-term glucocorticoids her medication must not be abruptly discontinued to avoid adrenal suppression

The client may develop low blood pressure

The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection

The use of long-term glucocorticoids may have contributed to a spike in blood glucose levels

The client will most likely experience more pain

Answer and Explanation

Correct Answer : A,C,D

The nurse must consider the following when obtaining a health history for a client with diabetes mellitus who has been taking glucocorticoids (prednisone) long-term for uncontrolled COPD:

Due to the use of long-term glucocorticoids, the medication must not be abruptly discontinued to avoid adrenal suppression. Abruptly stopping glucocorticoids can lead to adrenal insufficiency and a potentially life-threatening condition. Gradual tapering of the medication is necessary under medical supervision.
The use of long-term glucocorticoids may contribute to a spike in blood glucose levels. Glucocorticoids can cause insulin resistance and increase blood sugar levels, which can be problematic for individuals with diabetes mellitus.
The use of long-term glucocorticoids places the client at risk for increased susceptibility to infection. Glucocorticoids can suppress the immune system, making the client more susceptible to infections. This is important to consider, especially in a hospital setting where the risk of acquiring infections may be higher.

Regarding the other options:

The client may develop low blood pressure: While glucocorticoids can cause fluid retention and increased blood pressure, they are not typically associated with low blood pressure.

The client will most likely experience more pain: The use of glucocorticoids is not directly related to increased pain perception. Pain management may be influenced by various factors, but it is not specifically attributed to long-term glucocorticoid use.

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Correct Answer is B

Explanation

During an acute asthma attack, the airways become narrowed and inflamed, leading to symptoms such as wheezing, shortness of breath, and chest tightness. Short-acting beta2 agonists like Albuterol are the first-line medication for relieving acute asthma symptoms. They work by quickly relaxing the smooth muscles in the airways, resulting in bronchodilation and improved airflow. Albuterol provides rapid relief of symptoms and is often administered via inhalation.
A. Long-acting beta2 agonists (e.g., salmeterol) are typically used as maintenance therapy for long-term control of asthma symptoms, rather than for immediate relief during an acute attack.
C. Corticosteroids (e.g., fluticasone) are anti-inflammatory medications that are often prescribed for asthma, but they are more commonly used as part of a long-term management plan and may not provide immediate relief during an acute attack.
D. Anticholinergics (e.g., ipratropium) are sometimes used in combination with short-acting beta2 agonists for acute asthma exacerbations, but they are not typically the initial treatment choice for an acute asthma attack.

A. Rebound pulmonary congestion B. Hyperglycemia C. Adrenocortical insufficiency D. Severe dehydration

Correct Answer is C

Explanation

Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis.

Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency.

Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.

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A client with diabetes mellitus is being admitted to the hospital for surgery. The client has been taking Glucocorticoids (Prednisone) long-term for uncontrolled COPD. Which of the following must the nurse consider when she is obtaining a health history? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is in an urgent care center with an acute asthma attack. The nurse expects which medication will be used for initial treatment.

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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