Author Question: What would the nurse expect to assess in a client who has been taking long-term corticosteroid ... (Read 78 times)

sabina · **on:** Jul 23, 2018

What would the nurse expect to assess in a client who has been taking long-term corticosteroid replacement therapy?

Standard Text: Select all that apply.
1. Fasting blood glucose level 150 mg/dL
2. Reduced muscle mass
3. Elevated blood lipid levels
4. History of pathological fractures
5. Serum potassium level 5.0 mg/dL

Question 2

Which client statement indicates that instruction about fludrocortisone (Florinef) has been ineffective?

1. If I develop muscle cramps, I will call the office right away.
2. If I notice a lot of swelling in my legs, I'll call the office right away.
3. This drug could lower my potassium, so I'll eat foods rich in potassium.
4. This drug will drop my blood pressure, so I'll go from sitting to standing slowly.

olivia_paige29 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,2,3,4
Rationale 1: Corticosteroids have a hyperglycemic effect and increase the blood glucose level.
Rationale 2: Corticosteroids increase the breakdown of proteins to amino acids. Amino acids are then converted to glucose and glycogen in the liver, resulting in protein depletion.
Rationale 3: Corticosteroids increase the breakdown of lipids.
Rationale 4: Corticosteroids increase the breakdown of bony matrix, resulting in bone demineralization, which can cause pathological fractures.
Rationale 5: Corticosteroids do not increase the serum potassium level.
Global Rationale: Corticosteroids have a hyperglycemic effect and increase the blood glucose level. Corticosteroids increase the breakdown of proteins to amino acids. Amino acids are then converted to glucose and glycogen in the liver, resulting in protein depletion. They also increase the breakdown of lipids and cause bone demineralization. They do not increase serum potassium.

Answer to Question 2

Correct Answer: 4
Rationale 1: Muscle cramping could be a sign of hypokalemia.
Rationale 2: Peripheral edema could be a sign of fluid volume excess, and should be evaluated.
Rationale 3: This medication could lower potassium levels. The client can continue to enjoy foods rich in potassium.
Rationale 4: This medication is likely to cause the client's blood pressure to rise, not drop.
Global Rationale: This medication is likely to cause the client's blood pressure to rise, not drop. This medication could lower potassium levels causing muscle cramps. The client can continue to enjoy foods rich in potassium. Peripheral edema could be a sign of fluid volume excess, and should be evaluated.