A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching?
Increase carbohydrate intake.
Decrease protein intake.
Increase intake of calcium and vitamin D.
Limit intake of potassium-rich foods.
The Correct Answer is C
Rationale:
A. Increasing carbohydrate intake is not recommended for clients with Cushing's disease as they are already at risk for hyperglycemia and weight gain due to the effects of excess cortisol.
B. Decreasing protein intake is not advisable because clients with Cushing's disease often suffer from muscle wasting and weakness. Adequate protein is necessary to help maintain muscle mass.
C. Clients with Cushing's disease should increase their intake of calcium and vitamin D because they are at risk for osteoporosis due to the effects of chronic corticosteroid exposure, which can lead to decreased bone density.
D. Clients with Cushing's disease often experience hypokalemia (low potassium levels), so limiting potassium-rich foods would not be beneficial. Instead, they should ensure adequate potassium intake.
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Correct Answer is C
Explanation
Rationale:
A. Ondansetron is an antiemetic that does not typically cause nephrotoxicity and is generally safe for use in clients with chronic kidney disease.
B. Diphenhydramine is an antihistamine that does not have nephrotoxic effects and is commonly used for allergy symptoms or as a sleep aid.
C. Gentamicin is an aminoglycoside antibiotic that is known to be nephrotoxic, especially in clients with pre-existing kidney disease. It requires careful monitoring of kidney function and dosing adjustments to prevent kidney damage.
D. Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD) and does not typically cause nephrotoxicity, although long-term use has been associated with an increased risk of chronic kidney disease.
Correct Answer is C
Explanation
Rationale:
A. Discomfort at the puncture site is expected after a thoracentesis and typically managed with analgesics.
B. A decreased temperature is not a common complication of thoracentesis and might indicate other issues, but it is not immediately alarming.
C. An increased heart rate (tachycardia) could be a sign of a pneumothorax, hemorrhage, or other serious complications following thoracentesis. This requires immediate assessment and intervention.
D. Serosanguineous drainage is expected to some extent, but it should be monitored for changes that might indicate a complication such as infection or continued bleeding.