Author Question: The client with chronic obstructive pulmonary disease (COPD) is being changed from an oral ... (Read 34 times)

karlynnae · **on:** Jul 22, 2018

The client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone (Azmacort) by inhalation.

The nurse plans to monitor the client for which of the following signs and symptoms during the change? 1. Chills, fever, generalized rash
2. Vomiting and diarrhea, increased thirst
3. Blurred vision, headache, and insomnia
4. Anorexia, nausea, weakness, and fatigue

Question 2

The nurse hears in intershift report that a client receiving parenteral nutrition (PN) at 100 mL/hr has bilateral crackles and 1+ pedal edema. When the nurse obtains a daily weight, the nurse notes that the client has gained 4 lb in 2 days.

Which of the following nursing actions should the nurse take first? 1. Encourage the client to cough and deep-breathe.
2. Compare the intake and output records of the last 2 days.
3. Slow the PN infusion rate to 50 mL/hr per infusion pump.
4. Administer the prescribed daily diuretic, and check the client in 2 hours.

Li Jun · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

4

Rationale: Triamcinolone (Azmacort) is an adrenocortical steroid. The client who is being changed from an oral to an inhalation glucocorticoid could experience signs of adrenal insufficiency. The nurse should monitor the client for anorexia, nausea, weakness, and fatigue. The nurse should also monitor for hypotension and hypoglycemia.

Answer to Question 2

2

Rationale: The client is showing signs of fluid retention and possible excess fluid intake, as not-ed by the presence of crackles, edema, and weight gain. Noting the client's intake and output records adds to the database of information, which should then be reported. The problem may or may not be related to the PN. (Other possible causes are impaired respiratory, cardiovascular, or renal function.)