Which information obtained by the nurse in the clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?
Patient's blood pressure is 148/84 mm Hg.
Patient has not been taking the prescribed vitamin D.
Patient stopped taking the prednisone abruptly 2 days ago.
Patient has bilateral 2+ pitting ankle edema.
The Correct Answer is C
Choice A reason: An elevated blood pressure of 148/84 mm Hg is significant and could be related to prednisone use, as corticosteroids can increase blood pressure. However, this finding alone is not as urgent as the abrupt cessation of prednisone, which can lead to adrenal insufficiency and other serious complications.
Choice B reason: Not taking prescribed vitamin D is important, especially in long-term corticosteroid therapy, as vitamin D helps mitigate the risk of bone density loss. However, this issue is not as immediately critical as abruptly stopping prednisone.
Choice C reason: Stopping prednisone abruptly after taking it for 3 weeks is critical information that must be reported to the healthcare provider immediately. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce natural steroids. Abrupt discontinuation can lead to adrenal insufficiency, which can be life-threatening. Symptoms of adrenal insufficiency include severe fatigue, weakness, body aches, low blood pressure, and potential shock. Gradual tapering is required to allow the adrenal glands to recover and resume natural steroid production.
Choice D reason: Bilateral 2+ pitting ankle edema is a notable finding and may indicate fluid retention, which can be a side effect of prednisone. While it is important and requires monitoring, it does not carry the same immediate risk as the abrupt cessation of the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Reassessing vital signs in 1 hour is not an immediate action and does not address the patient’s current symptoms of dizziness and unsteady gait, which indicate a potential problem that requires immediate attention. Waiting an hour to reassess may delay necessary interventions that could prevent harm.
Choice B reason: Assisting the patient into a sitting position and notifying the healthcare provider is the most appropriate action. The symptoms of dizziness and unsteady gait, along with a BP of 98/60 mmHg, suggest that the patient may be experiencing orthostatic hypotension or a side effect of Carbidopa-Levodopa. Elevating the patient's position can help prevent falls, and notifying the healthcare provider ensures that the situation is assessed and managed promptly. This action addresses the immediate safety of the patient and facilitates appropriate medical intervention.
Choice C reason: Administering the next dose of Carbidopa-Levodopa early is not recommended without specific orders from the healthcare provider. It could potentially lead to overmedication and worsen the patient’s symptoms or cause adverse effects. Medication administration should always follow the prescribed schedule unless otherwise directed by the healthcare provider.
Choice D reason: Educating the patient about increasing his exercise is important for overall health and mobility but is not an immediate intervention for the acute symptoms of dizziness and unsteady gait. The patient’s current condition requires prompt assessment and intervention rather than education on exercise, which can be addressed later once the immediate issue is managed.
Correct Answer is ["C","E"]
Explanation
Choice A reason: ACE inhibitors are primarily used to treat high blood pressure and heart failure, but they are not typically the first line of treatment for peripheral artery disease (PAD). While they may be prescribed to manage underlying conditions that contribute to PAD, they are not specifically targeted at improving blood flow in the affected arteries.
Choice B reason: Antibiotics are used to treat bacterial infections and have no role in the management of peripheral artery disease (PAD). They do not address the underlying causes or symptoms of PAD and are not included in the treatment regimen for this condition.
Choice C reason: Statins are commonly prescribed to patients with peripheral artery disease (PAD) as they help lower cholesterol levels and reduce the risk of plaque buildup in the arteries. By lowering LDL cholesterol and stabilizing plaques, statins can improve blood flow and reduce the progression of PAD.
Choice D reason: Beta-blockers are used to manage high blood pressure and heart conditions, but they are not typically used as a primary treatment for peripheral artery disease (PAD). While they may be prescribed to manage underlying cardiovascular conditions, they do not directly improve blood flow in the affected arteries.
Choice E reason: Antiplatelet agents, such as aspirin and clopidogrel, are commonly prescribed to patients with peripheral artery disease (PAD) to prevent blood clots from forming in the arteries. By inhibiting platelet aggregation, these medications help improve blood flow and reduce the risk of complications associated with PAD.
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