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. Hyperparathyroidism often leads to elevated levels of calcium in the blood, which can result in joint and bone pain due to the excessive breakdown of bone tissue (osteoporosis).
B. Tremors are not typically associated with hyperparathyroidism; they are more commonly linked to conditions like hyperthyroidism or neurological disorders.
C. Swelling in the legs is more commonly associated with conditions like heart failure or venous insufficiency, not hyperparathyroidism.
D. Diarrhea is not a common symptom of hyperparathyroidism; this condition is more likely to cause constipation due to hypercalcemia.
Correct Answer is A
Explanation
Rationale:
A. Purulent dialysate outflow is a sign of infection, specifically peritonitis, which is a serious complication of peritoneal dialysis that requires immediate medical attention.
B. Blood-tinged dialysate can occur, especially if the client is new to dialysis or has had recent abdominal surgery, but it should be monitored rather than immediately reported unless it is excessive.
C. A feeling of fullness during the dialysate dwelling phase is common and usually resolves as the body adjusts to the procedure.
D. Discomfort during dialysate inflow can occur, particularly with fast inflow rates or high dialysate volumes, but it is not immediately life-threatening.