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

Answer and Explanation

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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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Bradycardia, or slow heart rate, is not typically associated with diabetes insipidus. The condition causes dehydration due to excessive water loss, leading to hypovolemia, which typically increases heart rate (tachycardia) to compensate for reduced blood volume, not slowing it, making bradycardia an unlikely sign.

Choice B reason: Oliguria, or low urine output, is not a feature of diabetes insipidus. The condition results from ADH deficiency, causing the kidneys to produce large volumes of dilute urine (polyuria). Oliguria is more common in conditions like acute kidney injury or dehydration from other causes.

Choice C reason: Hypotension is a clinical sign of diabetes insipidus due to significant water loss from polyuria, leading to hypovolemia. Reduced blood volume decreases blood pressure, as the cardiovascular system struggles to maintain adequate perfusion, making hypotension a common finding in severe or untreated cases.

Choice D reason: Hypertension is not typically associated with diabetes insipidus. The condition leads to dehydration and hypovolemia, which lower blood pressure. Hypertension might occur in conditions like SIADH, where water retention increases blood volume, but this is opposite to the pathophysiology of diabetes insipidus.

A. Teaching coughing and deep breathing techniques to help prevent infection B. Giving aspirin, as ordered, to control body temperature C. Administering platelets, as ordered, to maintain an adequate platelet count D. Administering stool softeners, as ordered, to prevent straining during defecation

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Teaching coughing and deep breathing techniques prevents respiratory infections but is not the primary intervention for immune thrombocytopenia (ITP). ITP involves autoimmune platelet destruction, increasing bleeding risk. While infection prevention is important, maintaining platelet counts through transfusion is more critical to prevent hemorrhage in ITP.

Choice B reason: Giving aspirin to control temperature is contraindicated in ITP, as aspirin inhibits platelet function, worsening bleeding risk in clients with low platelet counts. Fever management should use alternative antipyretics like acetaminophen, making aspirin administration inappropriate and potentially harmful in this condition.

Choice C reason: Administering platelets, as ordered, is a key intervention in immune thrombocytopenia when bleeding risk is high. ITP causes autoimmune destruction of platelets, leading to thrombocytopenia. Platelet transfusions restore counts, reducing the risk of spontaneous bleeding, such as intracranial or gastrointestinal hemorrhage, a critical concern in severe cases.

Choice D reason: Administering stool softeners prevents straining, which could cause bleeding in ITP due to low platelets. While useful, it is secondary to platelet transfusion, which directly addresses the primary issue of thrombocytopenia and bleeding risk, making it less urgent than restoring platelet counts.

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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)

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Naxlex Comprehensive Predictor Exams

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Explanation

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