The nurse has received SBAR report on a patient with Cush and ecchymoses on the upper extremity.
What action should the nurse implement first?
Notify the healthcare provider.
Administer insulin using the sliding scale.
Provide skin care after assessing the skin.
Monitor intake and output and daily weight.
The Correct Answer is A
Choice A rationale
Notifying the healthcare provider is the appropriate first action when significant ecchymosis is observed in a patient with Cushing's syndrome, as it may indicate a need for medical intervention.
Choice B rationale
Administering insulin is not relevant as the primary concern here is the ecchymosis, not hyperglycemia.
Choice C rationale
While providing skin care is important, it does not address the potential underlying cause of the ecchymosis, necessitating provider notification first.
Choice D rationale
Monitoring intake and output and daily weight is a general care measure but does not address the immediate concern of ecchymosis observed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Placing the patient in a private, lead-lined room is unnecessary for external radiation therapy, which does not make the patient radioactive. This consideration is more applicable to internal radiation therapy (brachytherapy), where radioactive materials are placed inside the body.
Choice B rationale
While dosimeter badges are essential for monitoring radiation exposure, they are more relevant for healthcare workers who may be exposed to radiation, not for patients receiving external radiation therapy. The patient themselves are not a source of radiation exposure.
Choice C rationale
Monitoring the patient's skin integrity is crucial because external radiation can cause skin irritation and damage. Avoiding exposure to extreme heat or cold helps prevent additional skin trauma and promotes healing.
Choice D rationale
Restricting visitors and posting radioactive precautions signs are unnecessary for patients receiving external radiation therapy. These precautions are more applicable to internal radiation therapy, where the patient may emit radiation.
Correct Answer is D
Explanation
Choice A rationale
Increasing the dose of corticosteroids without consulting a healthcare provider can be dangerous as it can cause serious side effects like immunosuppression, weight gain, and high blood pressure. Patients with Cushing's syndrome already have excess corticosteroids and should avoid additional doses.
Choice B rationale
This statement is incorrect as Cushing's syndrome is not related to a thyroid gland tumor. The treatment for Cushing's syndrome often involves removing a tumor from the adrenal gland or pituitary gland, not the thyroid.
Choice C rationale
Resuming physically intense activities like football should be discussed with a healthcare provider. Patients with Cushing's syndrome may have muscle weakness, osteoporosis, and other health issues that could be exacerbated by high-impact sports.
Choice D rationale
Patients with Cushing's syndrome have a weakened immune system due to high corticosteroid levels. Avoiding infections and promptly reporting any signs of illness, like fever, is crucial for their health.
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