Author Question: The nurse is caring for a client taking long-term hydrocortisone replacement therapy. Which ... (Read 28 times)

audragclark · **on:** Jul 23, 2018

The nurse is caring for a client taking long-term hydrocortisone replacement therapy. Which assessment finding indicates a masked infection?

1. A complaint of hiccups
2. Deformity of the left upper extremity
3. Purulent drainage from a puncture wound
4. A low-grade oral temperature

Question 2

The nurse recognizes that mineralocorticoid replacement therapy should be used judiciously in clients with:

1. hypotension.
2. aldosterone insufficiency.
3. heart failure.
4. Addison disease.

johnharpe · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: A complaint of hiccups is not indicative of a masked infection.
Rationale 2: Deformity of the upper left extremity does not indicate a masked infection.
Rationale 3: Purulent drainage is a direct sign of infection.
Rationale 4: Corticosteroids suppress the immune response. A low-grade fever in a client taking hydrocortisone replacement therapy is evidence that an infection is being masked.
Global Rationale: Corticosteroids suppress the immune response. A low-grade fever in a client taking hydrocortisone replacement therapy is evidence that an infection is being masked. Purulent drainage is a direct sign of infection. A complaint of hiccups and arm deformity are not indicative of a masked infection.

Answer to Question 2

Correct Answer: 3
Rationale 1: Hypotension should be corrected with mineralocorticoid replacement.
Rationale 2: Aldosterone insufficiency is an indication for mineralocorticoid replacement.
Rationale 3: Mineralocorticoid therapy should be used cautiously if a client has any disorders in which fluid accumulation could be hazardous.
Rationale 4: Addison disease is an indication for mineralocorticoid replacement.
Global Rationale: Mineralocorticoid therapy should be used cautiously if a client has any disorders in which fluid accumulation could be hazardous. Aldosterone insufficiency (Addison disease) is an indication for mineralocorticoid replacement. Hypotension should be corrected with mineralocorticoid replacement.