A nurse is providing dietary teaching for a client who has Cushing disease. Which of the following recommendations should the nurse include in the teaching?

Increase fluid intake.

Decrease protein intake.

Decrease carbohydrate intake.

Limit intake of potassium-rich foods.

Answer and Explanation

The Correct Answer is C

A. Increasing fluid intake is not recommended, as clients with Cushing disease often have fluid retention.
B. Decreasing protein intake is not recommended because muscle wasting is a concern in Cushing disease, and adequate protein is necessary to maintain muscle mass.
C. Decreasing carbohydrate intake is recommended because Cushing disease can cause hyperglycemia, and reducing carbohydrates can help manage blood glucose levels.
D. Limiting potassium-rich foods is not advisable as Cushing disease can lead to hypokalemia, and clients may need to increase their potassium intake.

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Correct Answer is B

Explanation

A. Epinephrine IM injection is not appropriate in this scenario, as it is typically reserved for treating anaphylactic shock. It is not used for septic shock where hypotension persists after fluid resuscitation.
B. Norepinephrine IV infusion is the correct choice. It is the first-line vasopressor in septic shock management when a fluid bolus does not adequately raise blood pressure. Norepinephrine works by constricting blood vessels, thereby increasing vascular resistance and blood pressure.
C. Dobutamine IV infusion might be considered if there is evidence of myocardial dysfunction or if additional inotropic support is necessary. However, it is not the immediate next step following fluid resuscitation when addressing persistent hypotension in septic shock.
D. Dexamethasone IV injection is not indicated for treating septic shock directly. It may be used in other contexts, such as treating adrenal insufficiency or reducing inflammation, but it does not play a role in immediate blood pressure management in septic shock.

A. "I will consult with my healthcare provider before taking over-the-counter medications." B. "I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours." C. "I will call the doctor if my illness lasts longer than 2 days." D. "I will call the doctor if my blood sugar is over 250 mg/dL or if I have protein in my urine."

Correct Answer is B

Explanation

A. Consulting with a healthcare provider before taking over-the-counter medications is appropriate, as some medications can affect blood glucose levels or interact with diabetes medications.
B. It is crucial for clients with diabetes to continue taking insulin during illness, even if they are unable to eat. Insulin needs may increase due to stress or infection, and not taking insulin could lead to hyperglycemia or diabetic ketoacidosis. Checking blood sugar every 2 hours is correct, but insulin should not be omitted.
C. Calling the doctor if the illness lasts longer than 2 days is a good practice, as prolonged illness can affect diabetes management and may require medical intervention.
D. Calling the doctor if blood sugar is over 250 mg/dL or if there is protein in the urine is appropriate, as these conditions can indicate complications that need medical attention.

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A nurse is providing dietary teaching for a client who has Cushing disease. Which of the following recommendations should the nurse include in the teaching?

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