Mr. Johnson, a 57-year-old male, was recently diagnosed with severe allergic asthma. His provider prescribes prednisone (a corticosteroid) to reduce inflammation and improve his breathing. He has been instructed to take 40 mg orally daily for the next 5 days, followed by a gradual taper. During the course of treatment. Mr. Johnson reports feeling increasingly fatigued, experiencing swelling in his legs, and noticing a weight gain of 3 pounds over the last 3 days. He also mentions having difficulty sleeping. What is the nurse's primary concern regarding Mr. Johnson's symptoms (fatigue, swelling, weight gain, difficulty sleeping while on prednisone therapy?
These symptoms are signs of an allergic reaction to the medication.
These are expected side effects of short-term corticosteroid use.
These symptoms may indicate fluid retention and potential electrolyte imbalances
These symptoms are due to an underlying infection caused by the medication.
The Correct Answer is C
A. These symptoms are signs of an allergic reaction to the medication.: Allergic reactions to prednisone are uncommon and usually present with rash, itching, or anaphylaxis rather than fatigue, edema, or weight gain. Mr. Johnson’s symptoms do not align with typical hypersensitivity responses.
B. These are expected side effects of short-term corticosteroid use.: While short-term prednisone use can cause minor side effects such as mood changes or insomnia, significant fluid retention, rapid weight gain, and swelling are more concerning and not typical of brief therapy.
C. These symptoms may indicate fluid retention and potential electrolyte imbalances: Prednisone can cause sodium and water retention, leading to edema, rapid weight gain, and fatigue. Electrolyte disturbances, particularly hypokalemia, may also occur. Monitoring and notifying the provider is important to prevent cardiovascular complications.
D. These symptoms are due to an underlying infection caused by the medication.: Prednisone can suppress the immune system, increasing infection risk, but the described symptoms do not specifically indicate infection. Fatigue and swelling are more consistent with fluid and electrolyte effects rather than an infectious process.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hypertensive crisis: Glucocorticoid withdrawal does not trigger hypertensive crisis. Blood pressure changes may occur with long-term steroid use, but abrupt stopping is not associated with dangerous hypertension spikes.
B. Thyroid storm: Thyroid storm is related to uncontrolled hyperthyroidism and is not connected to stopping glucocorticoids. Steroids do not regulate thyroid hormone levels, so this is not a withdrawal risk.
C. Acromegaly: This condition involves excess growth hormone and has no relationship to glucocorticoid therapy. Discontinuing prednisone does not affect growth hormone secretion or lead to acromegaly.
D. Adrenocortical insufficiency: Long-term glucocorticoid use suppresses the adrenal glands, reducing endogenous cortisol production. Abrupt withdrawal can leave the body unable to respond to stress, causing hypotension, fatigue, and potentially life-threatening adrenal crisis. This is why a slow taper is essential.
Correct Answer is D
Explanation
A. Beta-adrenergic: While epinephrine does stimulate beta-adrenergic receptors to relax bronchial smooth muscle and improve airflow, it also affects other receptors. Limiting its classification to beta only does not capture its full range of action in anaphylaxis.
B. Alpha-adrenergic: Epinephrine’s alpha-adrenergic effects cause vasoconstriction, which helps raise blood pressure and reduce edema. However, it also has important beta-adrenergic effects, so alpha stimulation alone is incomplete.
C. Dopamine: Epinephrine does not act on dopamine receptors in the context of treating anaphylaxis. Dopamine receptor activity is unrelated to its primary emergency actions.
D. Alpha and beta adrenergic: Epinephrine is nonspecific because it stimulates both alpha and beta receptors. Alpha stimulation increases vascular tone to counter hypotension and edema, while beta stimulation dilates bronchioles and increases cardiac output, making it the drug of choice for severe allergic reactions.
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