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NurseDive Free Nursing Practice Question
A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
A. Rebound pulmonary congestion
B. Hyperglycemia
C. Adrenocortical insufficiency
Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis. Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency. Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.
D. Severe dehydration
This question is an excerpt from Nurse Dive's nursing test bank - ATI NUR 229 Pharmacology Test #1 OEK Proctored Exam. Take the full exam now
Full Explanation
Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis.
Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency.
Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.
Similar Questions
A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?
A. Administer the granules mixed with 20 oz of water.
Administering the granules mixed with 20 oz of water is not necessary. Montelukast granules can be administered directly into the mouth or mixed with a small amount of soft food (e.g., applesauce) if necessary. The specific instructions for administration should be provided by the healthcare provider or included in the product labeling.
B. Administer the medication 2 hr before exercise.
If you’re using it to prevent breathing problems related to exercise, take a single dose at least 2 hours before exercising. However, another dose cannot be taken within 24 hours.
C. Give the medication in the morning daily
Montelukast is a leukotriene receptor antagonist commonly used for the maintenance treatment of asthma in children and adults. The usual recommended dose is once daily in the evening, depending on the specific instructions from the healthcare provider.
D. Give the medication at the onset of wheezing
Administering the medication at the onset of wheezing is not the recommended approach. Montelukast is a daily maintenance medication for asthma and should be taken regularly as prescribed, regardless of wheezing symptoms. It is not intended to be used for immediate relief of wheezing or acute asthma symptoms. Short-acting bronchodilators are typically used for quick relief of wheezing or acute asthma symptoms.
Full Explanation
A. Administering the granules mixed with 20 oz of water is not necessary. Montelukast granules can be administered directly into the mouth or mixed with a small amount of soft food (e.g., applesauce) if necessary. The specific instructions for administration should be provided by the healthcare provider or included in the product labeling.
B. If you’re using it to prevent breathing problems related to exercise, take a single dose at least 2 hours before exercising. However, another dose cannot be taken within 24 hours.
C. Montelukast is a leukotriene receptor antagonist commonly used for the maintenance treatment of asthma in children and adults. The usual recommended dose is once daily in the evening, depending on the specific instructions from the healthcare provider.
D. Administering the medication at the onset of wheezing is not the recommended approach. Montelukast is a daily maintenance medication for asthma and should be taken regularly as prescribed, regardless of wheezing symptoms. It is not intended to be used for immediate relief of wheezing or acute asthma symptoms. Short-acting bronchodilators are typically used for quick relief of wheezing or acute asthma symptoms.
A nurse is providing discharge teaching to the parent of a child who is prescribed diphenhydramine 25 mg elixir every 4 hr as needed. The amount available is diphenhydramine elixir 12.5 mg/5 mL. How many mL should the nurse administer per dose?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Full Explanation
To determine the mL of diphenhydramine elixir to administer per dose, we need to calculate the dose based on the prescribed amount and the concentration of the elixir.
Given:
Prescribed dose: 25 mg Concentration of elixir: 12.5 mg/5 mL
We can set up a proportion to find the equivalent mL for the prescribed dose: 25 mg / x mL = 12.5 mg / 5 mL
Cross-multiplying and solving for x, we get:
25 mg * 5 mL = 12.5 mg * x mL 125 mg = 12.5 mg * x mL
125 mg / 12.5 mg = x mL 10 mL = x mL
Therefore, the nurse should administer 10 mL of diphenhydramine elixir per dose.
A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine?
A. "Administer the medication with food."
"Administer the medication with food": While taking diphenhydramine with food may help reduce the risk of stomach upset, it does not directly address the dry mouth side effect.
B. "Discontinue the medication and notify your provider.”
"Discontinue the medication and notify your provider": Discontinuing the medication without consulting the healthcare provider is not recommended unless specifically instructed to do so. Dry mouth is a common side effect of diphenhydramine and can be managed with supportive measures.
C. "Place a humidifier at your bedside every evening.”
"Place a humidifier at your bedside every evening": While using a humidifier can help add moisture to the air and potentially alleviate dryness in the environment, it is not a specific instruction for managing dry mouth caused by diphenhydramine.
D. “Chew on sugarless gum or suck on hard, sour candies."
Dry mouth is a common side effect of diphenhydramine, which is an antihistamine medication commonly used to relieve symptoms of allergies, including itching and rash. Chewing on sugarless gum or sucking on hard, sour candies can help stimulate saliva production and alleviate the discomfort of dry mouth.
Full Explanation
Dry mouth is a common side effect of diphenhydramine, which is an antihistamine medication commonly used to relieve symptoms of allergies, including itching and rash. Chewing on sugarless gum or sucking on hard, sour candies can help stimulate saliva production and alleviate the discomfort of dry mouth.
A. "Administer the medication with food": While taking diphenhydramine with food may help reduce the risk of stomach upset, it does not directly address the dry mouth side effect.
B. "Discontinue the medication and notify your provider": Discontinuing the medication without consulting the healthcare provider is not recommended unless specifically instructed to do so. Dry mouth is a common side effect of diphenhydramine and can be managed with supportive measures.
C. "Place a humidifier at your bedside every evening": While using a humidifier can help add moisture to the air and potentially alleviate dryness in the environment, it is not a specific instruction for managing dry mouth caused by diphenhydramine.