A nurse is caring for a client with Cushing’s syndrome. Which interventions would the nurse include in the client’s plan of care? (Select all that apply)
Monitor weight
Administer prescribed diuretics
Provide a high sodium diet
Report systolic BP greater than 139 mm Hg or diastolic BP greater than 89 mm Hg
Examine extremities for pitting edema
Correct Answer : A,B,D,E
Reasoning:
Choice A reason: Monitoring weight is essential in Cushing’s syndrome, as excess cortisol promotes fat redistribution and weight gain. Regular weight checks help assess disease progression or treatment response, as weight gain in the trunk and face is a hallmark, and changes may indicate fluid retention or metabolic shifts.
Choice B reason: Administering prescribed diuretics is appropriate in Cushing’s syndrome when fluid retention causes edema or hypertension. Diuretics reduce excess fluid volume due to cortisol’s mineralocorticoid effects, which increase sodium and water retention, helping manage symptoms like swelling and elevated blood pressure effectively.
Choice C reason: A high sodium diet is contraindicated in Cushing’s syndrome, as cortisol’s mineralocorticoid activity causes sodium retention, leading to fluid overload and hypertension. A low-sodium diet is typically recommended to mitigate these effects and reduce the risk of edema and cardiovascular complications.
Choice D reason: Reporting blood pressure above 139/89 mm Hg is critical, as Cushing’s syndrome often causes hypertension due to cortisol’s effects on sodium retention and vascular tone. Elevated blood pressure increases cardiovascular risk, and prompt reporting ensures timely intervention to prevent complications like stroke or heart failure.
Choice E reason: Examining extremities for pitting edema is important, as cortisol’s mineralocorticoid effects cause sodium and water retention, leading to edema. Regular assessment helps detect fluid overload early, guiding diuretic therapy and fluid management to prevent complications like heart failure in clients with Cushing’s syndrome.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Reasoning:
Choice A reason: Normal hematocrit is not typical in sickle cell anemia, a hemolytic disorder where red blood cells are destroyed prematurely due to abnormal hemoglobin (HbS). Chronic hemolysis reduces red blood cell mass, lowering hematocrit, making a normal value inconsistent with the disease’s pathophysiology.
Choice B reason: Low hematocrit is characteristic of sickle cell anemia due to chronic hemolysis. Sickled red blood cells have a shorter lifespan, reducing circulating red blood cells and hemoglobin, resulting in a decreased hematocrit. This reflects the anemia’s impact on oxygen-carrying capacity, a hallmark of the condition.
Choice C reason: High hematocrit is not associated with sickle cell anemia. Elevated hematocrit occurs in conditions like polycythemia, where red blood cell mass increases. Sickle cell anemia causes hemolysis, reducing red blood cells and hematocrit, making a high value inconsistent with the disease.
Choice D reason: A normal blood smear is not expected in sickle cell anemia. Blood smears show sickled red blood cells, anisocytosis, and poikilocytosis due to hemoglobin S polymerization. These abnormal findings contrast with a normal smear, which would not reflect the hemolytic and morphological changes of the disease.
Correct Answer is D
Explanation
Reasoning:
Choice A reason: DIC is not primarily an autoimmune disease complication. While autoimmune conditions may trigger inflammation, DIC results from widespread activation of coagulation pathways due to conditions like sepsis or trauma, leading to microthrombi and factor consumption, not direct autoimmune attack on body cells.
Choice B reason: Hemolytic processes destroying erythrocytes cause hemolytic anemia, not DIC. While hemolysis may contribute to inflammation, DIC is driven by systemic activation of coagulation, forming microthrombi that consume platelets and clotting factors, leading to bleeding, not primarily erythrocyte destruction.
Choice C reason: Immune-mediated platelet destruction occurs in conditions like immune thrombocytopenia, not DIC. DIC involves systemic clotting activation, consuming platelets and factors, causing both thrombosis and bleeding. The immune system does not directly target platelets in DIC’s pathophysiology, making this explanation inaccurate.
Choice D reason: DIC is caused by abnormal activation of the clotting pathway, triggered by conditions like sepsis or trauma, leading to excessive microthrombi formation in organs. This consumes platelets and clotting factors, causing bleeding tendencies.
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