The nurse is caring for a client diagnosed with Cushing's Syndrome. Which of the following actions should be the nurse's highest priority?
Implementing fall precautions
Address client's coping mechanisms due to physical changes
Teach client to avoid unnecessary exposure to others with infections
Encouraging client to use incentive spirometer for improved lung expansion
The Correct Answer is A
A. Clients with Cushing’s Syndrome often experience muscle weakness, osteoporosis, and a risk of fractures due to excess cortisol. Implementing fall precautions is the highest priority to prevent injury.
B. Addressing coping mechanisms is important but not as immediate a safety concern as fall prevention.
C. Avoiding infections is crucial due to immunosuppression from elevated cortisol; however, preventing falls remains a more immediate concern.
D. Encouraging incentive spirometer use may support lung function, but it is not the highest priority compared to preventing falls.
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Correct Answer is A
Explanation
A. The primary purpose of administering an osmotic diuretic, such as mannitol, is to lower ICP by promoting diuresis, which results in increased urinary output and decreases fluid volume in the brain.
B. Osmotic diuretics do not specifically reduce cerebral blood flow; rather, they work by reducing fluid volume and thus intracranial pressure.
C. While osmotic diuretics can help manage edema, their primary role is not solely to prevent the formation of cerebral edema but to actively reduce existing pressure.
D. Osmotic diuretics do not directly decrease brain oxygen consumption; their main function is to create an osmotic gradient that pulls fluid from the brain to reduce ICP.
Correct Answer is C
Explanation
A. A short-term, low-dose steroid use (one week) has minimal risk for adrenal suppression.
B. Three weeks of steroids increases risk, but daily use presents a higher risk.
C. Prolonged daily steroid use, especially in an older adult, poses the greatest risk for adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
D. Intermittent steroid use is less likely to cause adrenal insufficiency compared to daily long-term use.