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    NR293 pharmacology proctored exam 3

    Complete the following sentence by choosing from the lists of options. A nurse is caring for a client who is prescribed long-term corticosteroid therapy. The nurse should monitor the client's laboratory results for dropdown and teach the client to dropdown.

    Explanation & Rationale

    • hyperglycemia: Long-term corticosteroid therapy increases gluconeogenesis and decreases peripheral glucose uptake, leading to elevated blood glucose levels. Clients with or without preexisting diabetes are at risk for hyperglycemia and potential complications such as polyuria and delayed wound healing. Regular monitoring of glucose helps identify early metabolic disturbances and allows timely intervention with diet or medication adjustments. • never stop this drug abruptly: Abrupt discontinuation of long-term corticosteroid therapy can precipitate adrenal insufficiency because exogenous steroids suppress the hypothalamic-pituitary-adrenal axis. Gradual tapering is necessary to allow the adrenal glands to resume normal cortisol production. Education about tapering prevents life-threatening complications such as hypotension, fatigue, and electrolyte imbalances. • hyponatremia: Corticosteroids generally cause sodium retention rather than loss, increasing the risk of hypernatremia and fluid retention. Hyponatremia is not commonly associated with long-term corticosteroid therapy. Monitoring for sodium disturbances should focus on potential elevation rather than depletion. • hyperkalemia: Corticosteroids promote potassium excretion, which can lead to hypokalemia rather than hyperkalemia. Potassium levels should be monitored to detect low levels and prevent cardiac arrhythmias. Hyperkalemia is not an expected effect of corticosteroid therapy. • monitor for weight loss: Corticosteroids often cause weight gain due to fluid retention and increased appetite, not weight loss. Focusing on weight loss could misdirect nursing interventions. Instead, clients should monitor for weight gain and signs of edema or truncal obesity. • take on an empty stomach: Corticosteroids can irritate the gastric mucosa; therefore, they should be taken with food to reduce gastrointestinal discomfort. Taking them on an empty stomach increases the risk of gastritis or peptic ulcer formation.

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