For a client with an exacerbation of rheumatoid arthritis, the physician prescribes the corticosteroid prednisone (Deltasone). When caring for this client, the nurse should monitor for which adverse drug reactions?

Correct Answer: A

Rationale: Corticosteroids, like prednisone, are commonly associated with several adverse drug reactions. Increased weight is often observed due to fluid retention and increased appetite caused by corticosteroids. Hypertension can result from the sodium and water retention triggered by these medications. Insomnia is a common side effect of corticosteroids due to their stimulant effect on the central nervous system. It is important for the nurse to monitor the client for these adverse reactions and report any concerning symptoms to the healthcare provider for appropriate management.

Correct Answer: A

Rationale: Performing monthly breast self-examination (BSE) after menstruation is recommended because during this time, the breasts are less likely to be swollen or tender, which can help to ensure a more accurate examination. Engaging in BSE on a regular basis can help individuals become familiar with their breast tissue and better recognize any changes that may occur. By performing BSE monthly after menstruation, individuals can actively monitor their breast health and potentially detect any abnormalities or signs of breast cancer at an early stage.

Correct Answer: C

Rationale: In status asthmaticus, a severe and prolonged asthma attack can lead to inadequate ventilation due to airway obstruction. This results in retention of carbon dioxide (CO2) in the blood, leading to respiratory acidosis. As the CO2 levels rise, it combines with water in the blood to form carbonic acid, lowering the blood pH levels. Symptoms of respiratory acidosis can include shortness of breath, confusion, lethargy, and potentially life-threatening complications. Treatment for status asthmaticus aims to improve ventilation and restore normal blood gas levels to alleviate respiratory acidosis.

Correct Answer: D

Rationale: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes characterized by hyperglycemia, ketosis, and metabolic acidosis. The initial treatment for DKA requires correcting dehydration and electrolyte imbalances. Normal saline infusion is the preferred choice for initial fluid resuscitation in patients with DKA to address dehydration and restore intravascular volume. It helps improve organ perfusion and correct electrolyte imbalances such as hyponatremia and dehydration commonly seen in DKA patients. Administering normal saline helps replace lost fluids and improve circulation, which is crucial in the management of DKA. Potassium infusion may be needed later to replete potassium levels once the patient's kidney function has been assessed. NPH insulin infusion is not the initial treatment for DKA, although insulin therapy is an essential component of DKA management. 5% dextrose infusion is contraindicated in the initial treatment

Correct Answer: E

Rationale: Older adults should be closely monitored when receiving IV therapy because their defense mechanisms are less efficient (A) as they age, making them more susceptible to infections and complications from invasive procedures like IV therapy. Additionally, older adults are prone to reduced renal efficiency (C), which can affect their ability to excrete excess fluids and electrolytes properly. Monitoring for signs of fluid overload and renal impairment is crucial in this population to prevent adverse outcomes related to IV therapy.