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Chapter 14: Problem 28

Client teaching regarding long-term corticosterodd therapy should include: a. the need for periodic blood glucose assessment \(\mathrm{b}\). the need to take the medication late in the day to avoid insomia c. the possibility of enhanced wound healing d. the need for a diet low in iron

Short Answer

Expert verified
a. the need for periodic blood glucose assessment

Step by step solution

01

- Identify the Correct Needs for Long-Term Corticosteroid Therapy

Read through each option carefully and determine which ones align with proper client teaching for long-term corticosteroid use. Consider what is known about corticosteroids' effects on the body.
02

- Analyze Option (a)

Option (a) discusses the need for periodic blood glucose assessment. Long-term corticosteroid use can lead to hyperglycemia, so periodic blood glucose monitoring is indeed necessary.
03

- Analyze Option (b)

Option (b) suggests taking the medication late in the day to avoid insomnia. Corticosteroids typically should be taken early in the day to align with the body鈥檚 natural cortisol rhythm and to prevent insomnia.
04

- Analyze Option (c)

Option (c) mentions the possibility of enhanced wound healing. Corticosteroids are known to impair, not enhance, wound healing due to their immunosuppressive effects.
05

- Analyze Option (d)

Option (d) advises a diet low in iron. There is no specific need for a low iron diet when on long-term corticosteroid therapy. This is not supported by clinical guidelines.
06

- Conclusion

After carefully analyzing all options, determine which one correctly addresses a necessity in client teaching for long-term corticosteroid therapy. Option (a) accurately represents an important aspect of monitoring.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Blood Glucose Monitoring
Long-term corticosteroid therapy can significantly affect blood glucose levels. Corticosteroids can increase blood glucose, leading to hyperglycemia. Hence, regular blood glucose monitoring is crucial to prevent complications like diabetes.
It's essential to monitor blood glucose:
  • Before starting corticosteroid therapy
  • At regular intervals during treatment
  • When dosages are changed
Keeping a close eye on blood sugar levels helps in adjusting medication and diet as needed. This proactive approach ensures better health management.
Medication Timing
Taking corticosteroids at the right time of day is essential to minimize side effects. It's generally recommended to take them earlier in the day, aligning with the body's natural cortisol rhythm. This helps in reducing the risk of insomnia and other sleep disorders.
Here are some tips:
  • Take the medication in the morning, ideally after breakfast.
  • Maintain a consistent schedule to avoid missed doses.
  • If instructed by your healthcare provider, split higher doses into smaller ones throughout the day.
Proper timing can significantly improve the effectiveness and reduce the negative impacts of corticosteroids.
Wound Healing
Corticosteroids have immunosuppressive effects, which can impair wound healing. They reduce inflammation but also decrease the body鈥檚 ability to repair tissues, making wounds slower to heal.
Follow these steps to promote better wound healing while on corticosteroids:
  • Keep the wound clean and covered.
  • Avoid unnecessary pressure or friction on the wound area.
  • Follow a healthy diet rich in vitamins and minerals that promote healing, like Vitamin C and Zinc.
  • Consult your healthcare provider for any signs of infection or slow-healing wounds.
Paying close attention to wound care can prevent complications and support better recovery.
Dietary Guidelines
A well-balanced diet is critical while on long-term corticosteroid therapy to counteract its side effects. Although a low iron diet isn't necessary, there are other important dietary considerations:
  • Calcium and Vitamin D: Essential for preventing osteoporosis, which can be a side effect of corticosteroids.
  • Potassium: Helps in combating corticosteroid-induced potassium depletion. Include foods like bananas and spinach.
  • Low sodium: Reduces the risk of high blood pressure and fluid retention.
It's also a good idea to limit sugar intake to manage blood glucose levels effectively. Consulting with a registered dietitian can provide personalized dietary advice that supports overall well-being.

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Most popular questions from this chapter

The nurse is providing care for a client with mild liver damage due to hepatitis. The nurse is aware that this client may need reduced dosages of medications because a. the client's kidneys cannot eliminate medications at the usual rate. b. the drugs may accumulate in the client's body and produce toxicity. c. the rate of absorption will increase allowing more of the drug to enter the bloodstream. d. liver damage may cause drugs to bind to plasma proteins.

Clients receiving long-term cotticosteroid therapy may require dietary modifications. Which of the following statements is true about special diets for longterm corticosteroid therapy? a. A potassium-restricted diet may be needed due to sodium and water retention. b. A low-protein, low-carbohydrate diet may be needed to correct negative nitrogen balance. c. A potassium-restricted diet may be needed due to potassium retention. d. Increased calcium is encouraged to help prevent osteoporosis.

The bulk-forming laxatives should always be taken with a. \(30 \mathrm{ml}\) orange juice. b. \(45 \mathrm{ml} \mathrm{milk}\). c. \(40 z\) of any liquid. d. 240-300 ml of water or jusce.

When administering proton pump inhibitors to a client, the nurse understands that they act by a. suppressing gastric acid secretion by inhibiting the gastric pump in the parietal cells of the stomach. b. reducing gastric acid production by inhibiting the leukotriene activity in the stomach. c. increasing gastric acid secretion by increasing the gastric pump output- d. increasing gastric acid production by inhibiting the gastric pump in the stomach.

A client was prescribed both heparin (Calcileam) and warfarin (Coumadin) by the physician. When preparing to administer both of these anticoagulants, what rationale would the nurse consider appropriate? a. It takes 12-24 hours before the action of otal anticoagulants is evident. b. Heparin (Calcilean) is more effective when used with warfarin sodium (Coumadin). c. By administering an oral anticoagulant with heparin (Calcilean), the client needs less frequent administration of heparin. d. The client is less likely to experience adverse effects
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