Exhibits
The nurse prepares the client for discharge and educates him on his new prescription.
Which possible side effects of fluticasone should the nurse advise the client about? Select all that apply.
Hyperglycemia
Oral candidiasis
Hyperkalemia
Dry mouth
Dehydration
Hypoxia
Adrenal suppression
Correct Answer : A,B,D,G
A. Hyperglycemia: Fluticasone is an inhaled corticosteroid, which can cause systemic effects including elevated blood glucose levels, especially with long-term use or high doses. Clients with diabetes or at risk should monitor glucose closely.
B. Oral candidiasis: A common side effect of inhaled corticosteroids like fluticasone is oral candidiasis (thrush). This occurs due to local immunosuppression in the mouth, and proper rinsing after use can help prevent it.
C. Hyperkalemia: Fluticasone does not typically cause hyperkalemia. Electrolyte imbalances such as hypokalemia may occur with systemic corticosteroids but hyperkalemia is not common.
D. Dry mouth: Dry mouth can occur with inhaled corticosteroids due to local irritation or reduced saliva production, leading to discomfort and increased risk of oral infections.
E Dehydration: Dehydration is not a typical side effect of fluticasone inhalers. Fluid balance is generally not affected by inhaled corticosteroids at therapeutic doses.
F. Hypoxia: Fluticasone does not cause hypoxia. It is used to improve airway inflammation and breathing, thereby improving oxygenation.
G. Adrenal suppression: Prolonged use of corticosteroids, even inhaled forms like fluticasone, can suppress the hypothalamic-pituitary-adrenal (HPA) axis, reducing the body’s natural cortisol production. This is more common with high doses or systemic corticosteroids.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Use the cream only on intact skin: Topical corticosteroids like betamethasone should not be applied to open wounds or infected areas, as this can delay healing and worsen infection risk. Using it only on intact skin is an appropriate precaution.
B. Apply the cream to the area for 2 weeks: Betamethasone is typically prescribed for short-term use, often 1–2 weeks, to minimize the risk of skin thinning and systemic absorption. This duration aligns with safe therapy guidelines.
C. Limit exposure to direct sunlight: Corticosteroid use can make the skin more sensitive to sunlight and increase the risk of irritation. Limiting sun exposure is an appropriate preventive measure.
D. Cover the site with an occlusive dressing: Occlusive dressings significantly increase absorption of topical corticosteroids, raising the risk of local and systemic side effects. This method should only be used if specifically ordered by the healthcare provider.
Correct Answer is D
Explanation
A. Absence of xerostomia: Xerostomia (dry mouth) is a possible side effect of bethanechol but does not indicate the medication’s effectiveness in relieving urinary retention.
B. No terminal urinary dribbling: While terminal dribbling can be a symptom of urinary retention, its absence alone is not the most reliable indicator that bethanechol is effectively improving bladder emptying.
C. Denies stress incontinence: Stress incontinence is related to increased abdominal pressure and weak pelvic muscles, which is different from urinary retention. Denial of stress incontinence does not confirm the medication’s efficacy.
D. Urinary output equals intake: When urinary output matches intake, it indicates effective bladder emptying and resolution of urinary retention. This is the most direct and objective measure that bethanechol is working as intended.
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