A nurse is caring for a client with Cushing's syndrome. Which assessment findings would the nurse expect? (Select all that apply.)
Purple striae
Moon face
Bronze pigmentation
Buffalo hump
Poor wound healing
Correct Answer : A,B,D,E
Rationale:
A. Purple striae (stretch marks) are common in Cushing's syndrome due to skin thinning and the redistribution of fat.
B. A "moon face" is a classic sign of Cushing's syndrome, caused by fat deposition in the face.
C. Bronze pigmentation is associated with Addison's disease, not Cushing's syndrome.
D. A "buffalo hump," or fat accumulation on the upper back, is another characteristic feature of Cushing's syndrome.
E. Poor wound healing is expected in Cushing's syndrome due to the effects of prolonged exposure to high cortisol levels, which impair immune function and tissue repair.
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Correct Answer is ["A","B","C","D","E","F"]
Explanation
Rationale:
A: Inhale deeply and then exhale completely: This step helps to empty the lungs, making room for the medication to be inhaled effectively.
B: Place her lips firmly around the mouthpiece: Ensuring a tight seal around the mouthpiece prevents the medication from escaping and ensures proper delivery to the lungs.
C: Breathe in deeply over 2 to 3 seconds while pushing down on the canister: Coordinating the inhalation with the activation of the canister ensures that the medication is inhaled deeply into the lungs.
D: Hold her breath for 10 seconds: Holding the breath allows the medication to settle in the lungs and increase its effectiveness.
E: Exhale slowly through pursed lips: This helps to maintain the medication in the lungs for as long as possible and promotes better absorption.
F: Wait 60 seconds between each puff: Waiting between puffs allows time for the medication to take effect and ensures that the next dose will be more effective.
Correct Answer is B
Explanation
Rationale:
A. A low sodium diet is not appropriate for a client with SIADH and hyponatremia, as it can exacerbate the low sodium levels. Increasing sodium intake might be more appropriate depending on the clinical situation.
B. Restricting fluid intake is a standard treatment for SIADH to prevent further dilution of sodium in the blood, which is critical in managing hyponatremia.
C. Desmopressin acetate is used to treat conditions with insufficient antidiuretic hormone, such as diabetes insipidus, and is not appropriate for SIADH.
D. An IV of 0.45% sodium chloride is hypotonic and could worsen hyponatremia in SIADH. Hypertonic saline would be more appropriate if IV treatment were necessary