Author Question: The nurse is evaluating outcomes for a client who has been using a nasal steroid consistently for ... (Read 35 times)

Awilson837 · **on:** Jul 23, 2018

The nurse is evaluating outcomes for a client who has been using a nasal steroid consistently for several months. Which is the desired outcome?

1. The client reports decreased nasal congestion.
2. The client's upper respiratory system is free of infection.
3. The client is free of wheezing.
4. The client's tonsils are pink and free of swelling and exudate.

Question 2

The nurse is teaching a client about beclomethasone (Beconase) nasal spray prior to discharge. Which side effects will the nurse prepare the client to manage?

1. Salt sensitivity and elevation of blood pressure
2. Nasal irritation and nosebleed
3. Bone demineralization and increased risk of fracture
4. Dyspepsia and gastric irritation

cam1229 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1
Rationale 1: Nasal steroids are indicated for control of allergic rhinitis. Nasal congestion, drainage, sneezing, and watery eyes should diminish after a month's use.
Rationale 2: Nasal steroids do not prevent infections.
Rationale 3: Nasal steroids do not decrease wheezing because they do not penetrate the lower airway.
Rationale 4: Nasal steroids do not protect the tonsils.
Global Rationale: Nasal steroids are indicated for control of allergic rhinitis. Nasal congestion, drainage, sneezing, and watery eyes should diminish after a month's use. Nasal steroids do not prevent infections. Nasal steroids do not decrease wheezing because they do not penetrate the lower airway. Nasal steroids do not protect the tonsils.

Answer to Question 2

Correct Answer: 2
Rationale 1: Hypertension and other signs of Cushing syndrome occur only if large amounts are absorbed systemically.
Rationale 2: Nasal steroids cause local irritation and might trigger nosebleeds. Systemic symptoms are uncommon.
Rationale 3: Bone demineralization and other signs of Cushing syndrome occur only if large amounts are absorbed systemically.
Rationale 4: Gastric upset and other signs of Cushing syndrome occur only if large amounts are absorbed systemically.
Global Rationale: Transient nasal irritation, burning, sneezing, dryness are common adverse effects of this drug. Hypercorticism with symptoms of hypertension, bone demineralization, and gastric upset may occur but only if large amounts are swallowed. Nasal ulceration leading to nosebleeds may occur. Use increases risk for Candida infection.