A nurse is teaching a client about the causes of osteoporosis. The nurse should include which of the following types of medication therapy as a risk factor for osteoporosis?

Choice A reason:

Tremors are not typically associated with Cushing’s syndrome. Cushing’s syndrome is characterized by an excess of cortisol, which leads to various symptoms, but tremors are not commonly among them. Tremors are more often associated with conditions affecting the nervous system, such as Parkinson’s disease or essential tremor.

Choice B reason:

A buffalo hump, which is a fat deposit on the back of the neck and upper back, is a common manifestation of Cushing’s syndrome. This occurs due to the redistribution of fat caused by prolonged exposure to high levels of cortisol. The buffalo hump is a distinctive physical sign that helps in diagnosing Cushing’s syndrome.

Choice C reason:

Moon face, characterized by a rounded, puffy face, is another hallmark of Cushing’s syndrome. This symptom results from fat deposits accumulating in the facial area due to elevated cortisol levels. The moon face is often one of the first noticeable signs of Cushing’s syndrome.

Choice D reason:

Hypertension, or high blood pressure, is a common symptom of Cushing’s syndrome. Cortisol increases blood pressure by enhancing the sensitivity of blood vessels to catecholamines and by promoting sodium and water retention. This leads to an increase in blood volume and, consequently, higher blood pressure.

Choice E reason:

Purple striae, or stretch marks, are also indicative of Cushing’s syndrome. These marks typically appear on the abdomen, thighs, breasts, and arms and are caused by the thinning of the skin and weakening of connective tissue due to excessive cortisol. The striae are often wide and have a purplish hue, distinguishing them from regular stretch marks.

Choice A reason: A private room in a quiet location on the unit is the best option for a client in the manic phase of bipolar disorder. This environment minimizes stimulation and distractions, which can help reduce agitation and hyperactivity. It also allows for better control of the client’s environment, which is crucial for managing manic symptoms.

Choice B reason: A private room across from the exercise room is not ideal because the proximity to the exercise room can increase stimulation and noise, potentially exacerbating manic symptoms. Clients in the manic phase need a calm and quiet environment to help stabilize their mood.

Choice C reason: A semi-private room across from the day room is also not suitable. The day room is typically a busy area with a lot of activity and noise, which can be overstimulating for a client in the manic phase. Sharing a room with another client can further increase the risk of agitation and conflict.

Choice D reason: A semi-private room across from the snack area is not recommended for similar reasons. The snack area is likely to have frequent traffic and noise, which can be disruptive. Additionally, sharing a room can lead to increased stimulation and potential conflicts with a roommate.