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 A
Explanation
Rationale:
A. Epoetin alfa is used to stimulate the production of red blood cells, so an increase in hematocrit levels would indicate a therapeutic effect. This is particularly important in clients with chronic renal disease, who often suffer from anemia due to decreased erythropoietin production by the kidneys.
B. The erythrocyte sedimentation rate (ESR) is a nonspecific measure of inflammation and is not used to monitor the effectiveness of epoetin alfa therapy.
C. The leukocyte count measures white blood cells and is not affected by or used to assess the effectiveness of epoetin alfa.
D. The platelet count measures platelets in the blood and is not related to the therapeutic effects of epoetin alfa, which targets red blood cell production.
Correct Answer is A
Explanation
Rationale:
A. Desmopressin is a synthetic analog of antidiuretic hormone (ADH) and is used to reduce urine output in conditions like diabetes insipidus. Monitoring urine output is the primary way to assess the effectiveness of this medication. A decrease in urine volume indicates the medication is working effectively.
B. Pupillary response is not relevant in assessing the effectiveness of desmopressin.
C. Temperature monitoring is important in general patient care but does not directly relate to the effectiveness of desmopressin.
D. Apical heart rate is important to monitor in many scenarios but is not a direct indicator of desmopressin's effectiveness.