A nurse is reinforcing teaching with a client who has COPD and has been taking long-term high doses of prednisone. Which of the following instructions should the nurse include in the teaching?

“Limit potassium-containing foods in your diet.”

"Withhold prednisone for 48 hours prior to receiving contrast dye.”

"Measure your blood glucose levels periodically.”

"Take prednisone on an empty stomach."

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is B

Explanation

A. Promethazine. Promethazine is an antihistamine used to treat nausea, vomiting, and allergic reactions. It does not have antihypertensive properties and does not lower blood pressure. Instead, it has sedative effects and is commonly used for motion sickness or as a preoperative medication.

B. Amlodipine. Amlodipine is a calcium channel blocker that lowers blood pressure by relaxing blood vessels and improving blood flow. It is commonly prescribed for hypertension and angina, as it reduces vascular resistance and decreases the workload on the heart. Clients taking amlodipine should be monitored for hypotension, edema, and dizziness.

C. Fluconazole. Fluconazole is an antifungal medication used to treat fungal infections such as candidiasis. It does not affect blood pressure regulation and is not used for managing hypertension. However, it can interact with certain medications, so monitoring for drug interactions is important.

D. Phenazopyridine. Phenazopyridine is a urinary analgesic used to relieve symptoms of urinary tract infections (UTIs), such as burning and pain during urination. It does not lower blood pressure and has no effect on cardiovascular function. Clients should be advised that this medication can cause orange discoloration of the urine.

A. Premedicate the client with diphenhydramine. B. Request a different route of administration from the provider. C. Administer the medication to the client. D. Request a different medication from the provider.

Correct Answer is C

Explanation

A. Premedicate the client with diphenhydramine. Premedicating with diphenhydramine is not necessary unless the client has a history of mild allergic reactions to erythromycin. Erythromycin is a macrolide antibiotic and does not have significant cross-reactivity with penicillin, making premedication unnecessary.

B. Request a different route of administration from the provider. Changing the route of administration does not address concerns about allergy. Erythromycin is well tolerated in clients with a penicillin allergy, and there is no indication that a different route would be required unless the client has difficulty swallowing or gastrointestinal intolerance.

C. Administer the medication to the client. Erythromycin belongs to the macrolide class and is commonly prescribed as an alternative for clients allergic to penicillin. There is no cross-reactivity between macrolides and penicillins, making erythromycin a safe and effective option for treating bacterial infections in these clients.

D. Request a different medication from the provider. There is no need to request an alternative medication unless the client has a known allergy to erythromycin. Since macrolides are safe for clients with penicillin allergies, withholding the medication without a valid reason could delay necessary treatment.

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A nurse is reinforcing teaching with a client who has COPD and has been taking long-term high doses of prednisone. Which of the following instructions should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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