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

Decrease protein intake.

Restrict sodium intake.

Limit intake of potassium-rich foods.

Increase carbohydrate intake.

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Decrease protein intake: This is not typically recommended for clients with Cushing’s disease. Protein is essential for maintaining muscle mass and overall health. Clients with Cushing’s disease often experience muscle weakness and wasting, so adequate protein intake is crucial to help counteract these effects. Therefore, decreasing protein intake would not be beneficial.

Choice B Reason:

Restrict sodium intake: Clients with Cushing’s disease often suffer from hypertension (high blood pressure) due to the excess cortisol in their bodies. High sodium intake can exacerbate this condition by increasing blood pressure even further. Therefore, it is crucial to restrict sodium intake to help manage hypertension and reduce the risk of cardiovascular complications. Foods high in sodium include processed foods, canned soups, and salty snacks. The recommended daily sodium intake for most adults is less than 2,300 milligrams, but for those with hypertension, it is often advised to consume even less.

Choice C Reason:

Limit intake of potassium-rich foods: This is not a standard recommendation for clients with Cushing’s disease. In fact, potassium is often beneficial as it can help counteract the effects of sodium and lower blood pressure. Potassium-rich foods include bananas, oranges, spinach, and sweet potatoes. Limiting these foods would not be advantageous and could potentially worsen hypertension.

Choice D Reason:

Increase carbohydrate intake: Increasing carbohydrate intake is not typically recommended for clients with Cushing’s disease. Excess cortisol can lead to increased blood sugar levels and a higher risk of developing diabetes. Therefore, it is important to manage carbohydrate intake carefully to avoid spikes in blood sugar. Instead, a balanced diet with a focus on complex carbohydrates, lean proteins, and healthy fats is recommended.

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Correct Answer is ["A","C","D","E","G"]

Explanation

Choice A Reason: Adherence to proper hand hygiene

Proper hand hygiene is a fundamental practice in preventing infections, including ventilator-associated pneumonia (VAP). Hand hygiene involves washing hands with soap and water or using an alcohol-based hand sanitizer before and after patient contact, after touching potentially contaminated surfaces, and before performing any aseptic procedures. This practice helps to reduce the transmission of pathogens that can cause infections in mechanically ventilated patients. Studies have shown that adherence to hand hygiene protocols significantly decreases the incidence of VAP and other healthcare-associated infections.

Choice B Reason: Suction the client at least every 2 hours

While suctioning is an important aspect of care for mechanically ventilated patients, routine suctioning every 2 hours is not recommended. Instead, suctioning should be performed based on the patient’s clinical condition and as needed. Over-suctioning can cause trauma to the airway and increase the risk of infection. Therefore, this choice is not included in the best practices for preventing VAP.

Choice C Reason: Administering antiulcer medication

Administering antiulcer medication is a recommended practice to prevent stress ulcers and gastrointestinal bleeding in mechanically ventilated patients. Stress ulcers can lead to complications such as aspiration of gastric contents, which can contribute to the development of VAP. Antiulcer medications, such as proton pump inhibitors or H2 receptor antagonists, help to reduce gastric acidity and the risk of ulcer formation. This practice is part of the comprehensive care plan to prevent VAP.

Choice D Reason: Providing oral care per protocol

Providing oral care per protocol is a critical component of VAP prevention. Oral care involves cleaning the patient’s mouth, teeth, and gums to reduce the colonization of harmful bacteria that can be aspirated into the lungs. Protocols for oral care typically include the use of antiseptic solutions, such as chlorhexidine, to disinfect the oral cavity. Regular oral care has been shown to significantly reduce the incidence of VAP in mechanically ventilated patients.

Choice E Reason: Elevating the head of the bed

Elevating the head of the bed to an angle of 30 to 45 degrees is a recommended practice to prevent VAP. This position helps to reduce the risk of aspiration of gastric contents into the lungs, which is a major risk factor for VAP. Elevating the head of the bed also promotes better lung expansion and ventilation, which can improve the patient’s respiratory status. This practice is widely recognized as an effective measure to prevent VAP.

Choice F Reason: Suctioning the client on a regular schedule

Similar to Choice B, routine suctioning on a regular schedule is not recommended. Suctioning should be performed based on the patient’s clinical needs and not on a fixed schedule. Over-suctioning can cause harm and increase the risk of infection. Therefore, this choice is not included in the best practices for preventing VAP.

Choice G Reason: Turning and positioning the client at least every 2 hours

Turning and positioning the client at least every 2 hours is an important practice to prevent complications such as pressure ulcers and to promote lung expansion. Regular repositioning helps to improve ventilation and drainage of secretions, reducing the risk of VAP. This practice is part of the standard care for mechanically ventilated patients to prevent various complications, including VAP.

A. You may bring some music to listen to for distraction. B. Do not take any sedatives 12 to 24 hours before the test. C. You will need to have someone to drive you home. D. Please do not have anything to eat or drink after midnight.

Correct Answer is B

Explanation

Choice A: You May Bring Some Music to Listen to for Distraction

Bringing music for distraction is generally not a standard instruction given before an EEG. While listening to music might help some patients relax, it is not a critical part of the preparation for the test. The primary focus of EEG preparation is to ensure accurate readings of brain activity, which can be influenced by various factors such as medication and sleep.

Choice B: Do Not Take Any Sedatives 12 to 24 Hours Before the Test

Avoiding sedatives before an EEG is crucial because these medications can alter brain activity and affect the test results. Sedatives can suppress the electrical activity in the brain, leading to inaccurate readings. Therefore, it is essential for patients to avoid taking any sedatives 12 to 24 hours before the test to ensure the EEG captures the brain’s natural activity.

Choice C: You Will Need to Have Someone to Drive You Home

This instruction is typically given if the patient is expected to be sedated or if the test involves procedures that might impair their ability to drive. However, for a standard EEG, patients are usually not sedated, and there is no need for someone to drive them home. This instruction is more relevant for other types of medical procedures that involve sedation.

Choice D: Please Do Not Have Anything to Eat or Drink After Midnight

Fasting is not a standard requirement for an EEG. Patients are generally allowed to eat and drink before the test. However, they are often advised to avoid caffeine as it can affect brain activity. The instruction to avoid food and drink after midnight is more commonly associated with procedures that require anesthesia or sedation, not an EEG.

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

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