A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Orthostatic hypotension

Hyperglycemia

Paresthesia

Jaundice

Answer and Explanation

The Correct Answer is B

A. Orthostatic hypotension. Prednisone does not typically cause orthostatic hypotension. Instead, corticosteroids can lead to fluid retention and hypertension due to their effects on sodium and water balance. Orthostatic hypotension is more commonly associated with medications such as diuretics or antihypertensives.

B. Hyperglycemia. Prednisone is a glucocorticoid that increases blood glucose levels by enhancing gluconeogenesis and reducing insulin sensitivity. This effect can make blood sugar more difficult to control in clients who take insulin, potentially requiring higher insulin doses to maintain glycemic control. Clients with diabetes or those taking insulin should closely monitor their blood glucose levels while on prednisone.

C. Paresthesia. Paresthesia (numbness or tingling) is not a common adverse effect of prednisone or a direct interaction with insulin. While uncontrolled diabetes can cause diabetic neuropathy, prednisone does not typically cause neurological symptoms like tingling.

D. Jaundice. Prednisone is not commonly associated with hepatotoxicity or liver dysfunction leading to jaundice. However, long-term corticosteroid use may increase liver enzyme levels, but it does not typically cause direct liver damage or bile obstruction. Jaundice would require evaluation for other underlying liver conditions.

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Correct Answer is C

Explanation

A. "Limit potassium-containing foods in your diet." Long-term prednisone use can lead to hypokalemia (low potassium levels) due to its mineralocorticoid effects, which increase potassium excretion. Clients on chronic corticosteroid therapy may actually need to consume potassium-rich foods to help maintain electrolyte balance, rather than restricting them.

B. "Withhold prednisone for 48 hours prior to receiving contrast dye." There is no general recommendation to withhold prednisone before contrast dye administration. However, clients on long-term steroid therapy may require stress-dose steroids if undergoing procedures that could trigger an adrenal crisis. Withholding prednisone without provider guidance could increase the risk of adrenal insufficiency.

C. "Measure your blood glucose levels periodically." Prednisone can cause hyperglycemia by increasing insulin resistance and promoting gluconeogenesis. Clients, especially those with diabetes or at risk for metabolic syndrome, should monitor blood glucose levels regularly to detect potential steroid-induced diabetes. Adjustments in diet or medication may be needed based on blood glucose trends.

D. "Take prednisone on an empty stomach." Taking prednisone on an empty stomach can increase the risk of gastrointestinal irritation, ulcers, and gastritis. It should be taken with food or milk to help reduce stomach irritation and minimize gastrointestinal side effects. Clients should be advised to follow this guideline to prevent discomfort and potential complications.

A. "Do not take more than 200 milligrams of this medication within 24 hours.” B. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists.” C. "You should discontinue this medication if pregnancy is planned or suspected.” D. "You might experience a rash on your skin while taking this medication." E. "You might experience a feeling of pressure in your chest after taking this medication." F. "This medication can cause you to feel tired." G. "This medication should start to alleviate the headache within 1 hour."

Correct Answer is ["A","B","C","E","F","G"]

Explanation

A. "Do not take more than 200 milligrams of this medication within 24 hours." This statement is correct for oral sumatriptan, which has a maximum recommended dose of 200 mg per 24 hours. Clients can take one 50 mg or 100 mg dose initially, and if the headache persists, a second dose can be taken after at least 2 hours, provided the total daily dose does not exceed 200 mg.

B. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists." A second dose of sumatriptan can be taken at least 2 hours after the first dose if the headache has not fully resolved. However, if the headache persists after the maximum daily dose (200 mg), the client should not take additional doses and should seek medical evaluation.

C. "You should discontinue this medication if pregnancy is planned or suspected." Sumatriptan is classified as Pregnancy Category C, meaning its effects on fetal development are not well studied. Clients who are pregnant or planning to conceive should consult their healthcare provider before using this medication.

D. "You might experience a rash on your skin while taking this medication." Skin rash is not a common side effect of sumatriptan. If a rash develops, it could indicate an allergic reaction, which should be reported to a provider. However, routine monitoring for rashes is not necessary when taking sumatriptan.

E. "You might experience a feeling of pressure in your chest after taking this medication." Chest tightness or pressure is a known side effect of sumatriptan due to its vasoconstrictive effects. This sensation is usually temporary and not dangerous, but if it becomes severe or persistent, the client should seek medical attention to rule out cardiovascular complications.

F. "This medication can cause you to feel tired." Fatigue, drowsiness, and dizziness are common side effects of sumatriptan. Clients should be cautious when driving or operating machinery until they know how the medication affects them.

G. "This medication should start to alleviate the headache within 1 hour." Sumatriptan typically begins to relieve migraine symptoms within 30 to 60 minutes when taken orally. If the headache does not improve after 2 hours, a second dose may be taken, but the total daily dose should not exceed 200 mg.

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A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Nursing Test Bank

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