A nurse is planning care for a client who has multiple sclerosis and is receiving methylprednisolone. Which of the following adverse effects should the nurse anticipate? (Select all that apply.)

Choice A rationale Methylprednisolone, a corticosteroid, typically causes hypertension rather than hypotension due to its mineralocorticoid effects, leading to sodium and water retention. It increases peripheral vascular resistance and cardiac output, contributing to elevated blood pressure. Normal blood pressure range is systolic less than 120 mmHg and diastolic less than 80 mmHg. Choice B rationale Bladder spasms are not a direct or anticipated adverse effect of methylprednisolone. While multiple sclerosis itself can cause bladder dysfunction, methylprednisolone primarily exerts anti-inflammatory and immunosuppressive effects, and does not directly target bladder smooth muscle contraction. Choice C rationale Methylprednisolone significantly increases the risk of hyperglycemia. Corticosteroids promote gluconeogenesis, reduce peripheral glucose utilization, and decrease insulin sensitivity, leading to elevated blood glucose levels. Normal fasting blood glucose is typically 70-99 mg/dL (3.9-5.5 mmol/L). Choice D rationale Methylprednisolone impairs wound healing. Corticosteroids suppress the inflammatory response, inhibit fibroblast proliferation, decrease collagen synthesis, and reduce angiogenesis, all of which are critical processes for effective tissue repair and wound closure, thus delaying healing.