NURS 2042 STUDY GUIDE WITH
COMPLETE SOLUTION
A nurse is caring for a patient who is prescribed a corticosteroid for
rheumatoid arthritis. After reviewing the patient's medical records, the nurse
learns that the patient is already taking a diuretic. Which complication does
the nurse anticipate in the patient?
1 Osteoporosis
2 Hyperglycemia
3 Visual disturbances
4 Increased potassium loss - ANSWER Increased potassium loss
Patients who concurrently take a corticosteroid with a diuretic are most likely
to experience increased potassium loss, leading to hypokalemia.
Osteoporosis and visual disturbances are adverse effects of long-term
glucocorticoid therapy. Hyperglycemia may be observed in diabetic patients
receiving corticosteroid therapy.
(37)
Which instructions would a nurse provide to a patient who is prescribed
corticosteroid therapy? Select all that apply.
,1 "Take the medication on an empty stomach."
2 "Change your position every 4 hours if edema is present."
3 "Report to your healthcare provider if you experience chest pain."
4 "Report to your healthcare provider if you notice a weight gain of 2 pounds
in 2 days."
5 "Report to your healthcare provider if you have general malaise, sore
throat, or a low-grade fever." - ANSWER 3 "Report to your healthcare
provider if you experience chest pain."
4 "Report to your healthcare provider if you notice a weight gain of 2 pounds
in 2 days."
5 "Report to your healthcare provider if you have general malaise, sore
throat, or a low-grade fever."
The nurse should instruct the patient to report to the healthcare provider if
angina (chest pain), significant weight gain, general malaise, sore throat, or a
low-grade fever develops. The nurse should instruct the patient to take the
medication with food to minimize gastric irritation. If the patient has edema,
the nurse should advise changing position every 2 hours and not every 4
hours.
(37)
For which adverse effect would the nurse monitor in the patient taking
fludrocortisone (Florinef) for the treatment of Addison's disease?
,1Hypokalemia
2Hyponatremia
3Hypercalcemia
4Hypermagnesemia - ANSWER Hypokalemia
Fludrocortisone (Florinef) is a mineralocorticoid and may cause hypokalemia.
Patients taking fludrocortisone (Florinef) may need to increase potassium
intake. Hypercalcemia is not an adverse effect of fludrocortisone (Florinef).
Hypernatremia may be an adverse effect and hypermagnesemia is not an
adverse effect of fludrocortisone (Florinef).
(37)
Which lifestyle modification would a nurse encourage to prevent calcium loss
in a patient receiving corticosteroid therapy?
1Calorie restrictions
2Increased fluid intake
3Weight-bearing exercises
4Active and passive range-of-motion exercises - ANSWER 3
Weight-bearing exercises
, The nurse should encourage the patient to get involved in weight-bearing
exercises to prevent calcium loss while on corticosteroid therapy. Calorie
restrictions should be encouraged in patients with weight gain problems.
Active and passive range-of-motion exercises may help maintain mobility
and joint and muscle integrity. The nurse should encourage a limitation of
fluid intake in patients receiving corticosteroid therapy to maintain fluid and
electrolyte balance.
(37)
Which patient receiving corticosteroid therapy would be most likely to
experience a reduced therapeutic effect of the corticosteroid?
1 Fludrocortisone and cortisone
2 Hydrocortisone and rifampin
3 Fludrocortisone and hydrocortisone
4 Hydrocortisone and thiazide - ANSWER Hydrocortisone and rifampin
Rifampin may increase the corticosteroid metabolism, which results in a
decreased therapeutic effect. Patient B is most likely to experience reduced
therapeutic effect of the corticosteroid. When cortisone or hydrocortisone is
administered along with fludrocortisone, an additional glucocorticoid effect
is caused. Concurrent administration of hydrocortisone and thiazide may
cause hypokalemia. Diuretics do not reduce the therapeutic effect of
corticosteroids.
COMPLETE SOLUTION
A nurse is caring for a patient who is prescribed a corticosteroid for
rheumatoid arthritis. After reviewing the patient's medical records, the nurse
learns that the patient is already taking a diuretic. Which complication does
the nurse anticipate in the patient?
1 Osteoporosis
2 Hyperglycemia
3 Visual disturbances
4 Increased potassium loss - ANSWER Increased potassium loss
Patients who concurrently take a corticosteroid with a diuretic are most likely
to experience increased potassium loss, leading to hypokalemia.
Osteoporosis and visual disturbances are adverse effects of long-term
glucocorticoid therapy. Hyperglycemia may be observed in diabetic patients
receiving corticosteroid therapy.
(37)
Which instructions would a nurse provide to a patient who is prescribed
corticosteroid therapy? Select all that apply.
,1 "Take the medication on an empty stomach."
2 "Change your position every 4 hours if edema is present."
3 "Report to your healthcare provider if you experience chest pain."
4 "Report to your healthcare provider if you notice a weight gain of 2 pounds
in 2 days."
5 "Report to your healthcare provider if you have general malaise, sore
throat, or a low-grade fever." - ANSWER 3 "Report to your healthcare
provider if you experience chest pain."
4 "Report to your healthcare provider if you notice a weight gain of 2 pounds
in 2 days."
5 "Report to your healthcare provider if you have general malaise, sore
throat, or a low-grade fever."
The nurse should instruct the patient to report to the healthcare provider if
angina (chest pain), significant weight gain, general malaise, sore throat, or a
low-grade fever develops. The nurse should instruct the patient to take the
medication with food to minimize gastric irritation. If the patient has edema,
the nurse should advise changing position every 2 hours and not every 4
hours.
(37)
For which adverse effect would the nurse monitor in the patient taking
fludrocortisone (Florinef) for the treatment of Addison's disease?
,1Hypokalemia
2Hyponatremia
3Hypercalcemia
4Hypermagnesemia - ANSWER Hypokalemia
Fludrocortisone (Florinef) is a mineralocorticoid and may cause hypokalemia.
Patients taking fludrocortisone (Florinef) may need to increase potassium
intake. Hypercalcemia is not an adverse effect of fludrocortisone (Florinef).
Hypernatremia may be an adverse effect and hypermagnesemia is not an
adverse effect of fludrocortisone (Florinef).
(37)
Which lifestyle modification would a nurse encourage to prevent calcium loss
in a patient receiving corticosteroid therapy?
1Calorie restrictions
2Increased fluid intake
3Weight-bearing exercises
4Active and passive range-of-motion exercises - ANSWER 3
Weight-bearing exercises
, The nurse should encourage the patient to get involved in weight-bearing
exercises to prevent calcium loss while on corticosteroid therapy. Calorie
restrictions should be encouraged in patients with weight gain problems.
Active and passive range-of-motion exercises may help maintain mobility
and joint and muscle integrity. The nurse should encourage a limitation of
fluid intake in patients receiving corticosteroid therapy to maintain fluid and
electrolyte balance.
(37)
Which patient receiving corticosteroid therapy would be most likely to
experience a reduced therapeutic effect of the corticosteroid?
1 Fludrocortisone and cortisone
2 Hydrocortisone and rifampin
3 Fludrocortisone and hydrocortisone
4 Hydrocortisone and thiazide - ANSWER Hydrocortisone and rifampin
Rifampin may increase the corticosteroid metabolism, which results in a
decreased therapeutic effect. Patient B is most likely to experience reduced
therapeutic effect of the corticosteroid. When cortisone or hydrocortisone is
administered along with fludrocortisone, an additional glucocorticoid effect
is caused. Concurrent administration of hydrocortisone and thiazide may
cause hypokalemia. Diuretics do not reduce the therapeutic effect of
corticosteroids.
