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Patient Data

Which possible side effects of fluticasone should the nurse advise the client about? Select all that apply.

Hyperglycemia

Dehydration

Dry mouth

Oral candidiasis

Hypoxia

Adrenal suppression

Hyperkalemia

Answer and Explanation

Correct Answer : C,D,E

A. Hyperglycemia: While systemic corticosteroids can cause hyperglycemia, inhaled corticosteroids like fluticasone have minimal systemic absorption and rarely lead to significant blood sugar elevations unless used at very high doses over a long time.

B. Dehydration: Dehydration is not a known side effect of fluticasone. This medication acts locally in the respiratory tract and does not impact overall fluid balance significantly.

C. Dry mouth: Inhaled corticosteroids like fluticasone can cause dry mouth or throat irritation due to reduced salivary flow and local mucosal dryness. Clients should be instructed to rinse their mouth after use to minimize discomfort.

D. Oral candidiasis: Oral candidiasis (thrush) is a common side effect of inhaled corticosteroids because the steroid can suppress local immune responses, allowing fungal overgrowth in the mouth. Rinsing the mouth after each inhalation helps prevent this complication.

E. Hypoxia: Fluticasone improves airway inflammation and reduces the risk of hypoxia by enhancing lung function. It does not cause or worsen hypoxia as a side effect.

F. Adrenal suppression: Although rare with low-dose inhaled steroids, adrenal suppression can occur with long-term, high-dose use due to absorption of corticosteroids into the bloodstream. Monitoring and using the lowest effective dose help minimize this risk.

G. Hyperkalemia: Fluticasone does not significantly affect potassium levels. Hyperkalemia is not a recognized side effect of inhaled corticosteroids.

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Correct Answer is ["C","D","E","F"]

Explanation

A. Propofol: Propofol is a powerful sedative used mainly for anesthesia or sedation during mechanical ventilation. It is not appropriate or expected for routine postoperative pain management with morphine on a surgical floor.

B. Methadone: Methadone is another opioid used for chronic pain management or opioid dependency, not typically prescribed alongside morphine for acute postoperative pain because combining opioids increases the risk of respiratory depression.

C. Docusate sodium: Docusate sodium is a stool softener often prescribed with opioids like morphine to prevent constipation, a common opioid side effect. Promoting bowel movements is an important preventative measure in postoperative patients.

D. Ibuprofen: Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), may be prescribed to provide additional pain relief through a different mechanism and reduce inflammation. This combination allows lower opioid doses, improving pain management while minimizing opioid side effects.

E. Naloxone: Naloxone is an opioid antagonist kept available as a safety measure in case of opioid-induced respiratory depression. Having naloxone ordered and readily accessible is a critical precaution during opioid therapy.

F. Senna: Senna is a stimulant laxative that can be prescribed along with docusate to prevent or treat opioid-induced constipation by actively stimulating bowel movements, making it a commonly expected medication alongside opioids.

A. Do you perform regular testicular self examinations? B. Are you taking any type of anabolic steroids? C. Do you use any type of herbal supplements? D. How many hours a day do you spend exercising?

Correct Answer is B

Explanation

A. Do you perform regular testicular self-examinations?: While important for early detection of testicular cancer, this question does not directly address the concern about testicular shrinkage, which is more likely linked to hormonal influences or substance use.

B. Are you taking any type of anabolic steroids?: Anabolic steroid use can suppress natural testosterone production, leading to testicular atrophy or shrinkage. Identifying steroid use is critical because it directly relates to the reported symptom and can have significant long-term health consequences.

C. Do you use any type of herbal supplements?: Herbal supplements can sometimes affect hormone levels, but they are far less likely than anabolic steroids to cause noticeable testicular shrinkage.

D. How many hours a day do you spend exercising?: While excessive exercise can impact overall hormonal balance, it is unlikely by itself to cause significant testicular shrinkage. Directly investigating anabolic steroid use is a much higher priority based on the symptom described.

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Patient Data Which possible side effects of fluticasone should the nurse advise the client about? Select all that apply.

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Explanation

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Patient Data

Which possible side effects of fluticasone should the nurse advise the client about? Select all that apply.