A client with Type 2 diabetes, controlled with diet and metformin, also has chronic obstructive pulmonary disease (COPD). During an exacerbation of COPD, the client is prescribed prednisone to control inflammation. For which side effect should the nurse monitor the client?
Increased blood glucose levels.
Increased potassium levels.
Increased white blood cell count.
Increased ketones in the urine.
The Correct Answer is A
Choice A reason:
Prednisone is a corticosteroid that can cause hyperglycemia, especially in clients with diabetes. The nurse should monitor blood glucose levels because prednisone can increase insulin resistance and hepatic glucose production, leading to elevated blood glucose levels. Normal fasting blood glucose levels range from 70 to 99 mg/dL, and for individuals with diabetes, maintaining blood glucose levels within the target range set by their healthcare provider is crucial to prevent complications.
Choice B reason:
While corticosteroids can affect electrolyte balance, they typically cause a decrease in potassium levels, not an increase. Therefore, monitoring for hypokalemia, rather than hyperkalemia, would be more appropriate when a patient is on prednisone. The normal range for serum potassium is 3.5 to 5.0 mEq/L.
Choice C reason:
Corticosteroids like prednisone can cause leukocytosis, an increase in white blood cell count, as part of their immunosuppressive action. However, this is generally not a harmful side effect unless accompanied by infection or other complications. The normal range for white blood cell count is approximately 4,500 to 11,000 cells per microliter.
Choice D reason:
Increased ketones in the urine, or ketonuria, is not a typical side effect of prednisone. Ketonuria is more commonly associated with uncontrolled diabetes, particularly Type 1 diabetes, when there is an insulin deficiency and the body resorts to fat breakdown, leading to ketone production.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Dantrolene is used in the management of malignant hyperthermia, a life-threatening complication characterized by muscle rigidity and elevated temperature, often triggered by certain anesthetics. The patient's symptoms of muscle rigidity and brown urine, which may indicate myoglobinuria, along with elevated temperature and heart rate, are suggestive of this condition. Dantrolene acts by reducing calcium release from the sarcoplasmic reticulum of skeletal muscle, thereby reducing muscle contraction and metabolic demand.
Choice B Reason:
Metoprolol, a beta-blocker, is not the first-line treatment for symptoms suggestive of malignant hyperthermia. While it can reduce heart rate and blood pressure, it does not address the underlying pathophysiology of malignant hyperthermia and is not indicated in this scenario.
Choice C Reason:
Increasing the rate of lactated Ringer's solution is not the primary intervention for malignant hyperthermia. While maintaining hydration is important, it does not directly counteract the pathophysiological processes at play in malignant hyperthermia.
Choice D Reason:
While liver function tests can be important in assessing overall organ function post-operatively, they are not the immediate priority in a suspected case of malignant hyperthermia. The priority is to treat the acute and life-threatening symptoms first.
Correct Answer is B
Explanation
Choice A Reason
While some medications for hypertension can cause visual side effects, it is not the most immediate concern when a patient reports blurred vision. Medication-related side effects are important to consider, but they typically present consistently rather than intermittently.
Choice B Reason
An ophthalmic examination is crucial for evaluating intermittent blurred vision in a client with hypertension. Hypertension can lead to hypertensive retinopathy, where high blood pressure causes damage to the blood vessels in the retina, potentially resulting in blurred vision or vision loss. An eye exam can help diagnose this condition and prevent further complications.
Choice C Reason
Blurred vision can indeed be associated with hypertension, particularly in severe cases or hypertensive crises. However, it is not considered a 'common' problem but rather a sign of potential end-organ damage, such as hypertensive retinopathy, which requires prompt medical evaluation.
Choice D Reason
The risk of brain tumors is not directly associated with hypertension. While hypertension is a risk factor for certain conditions like stroke, it is not typically linked with an increased risk of brain tumors. This choice might cause unnecessary alarm without a clinical basis.
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