Nokea
A client is taking the immunosuppressant medication, azathioprine (Imuran), for the treatment of Crohn's disease. What statement made by the client demonstrates an understanding of the side effects of this medication?
- A. I will notify the doctor if I have a fever or any other signs of infection.'
- B. I will drink at least 3 L of fluid per day.'
- C. I will notify the doctor if I am not having a bowel movement daily.'
- D. I will stop taking my medication if I notice any side effects and then notify the doctor.'
Correct Answer: A
Rationale: The client should be instructed to be sure to report any signs of infection since this drug suppresses the immune system and makes the client susceptible to infections. It is important for a client to drink 3 L of fluid when taking the immunosuppressant drug cyclosporine to prevent hemorrhagic cystitis, but this is not necessary for azathioprine. It is not necessary to inform the physician if the client is not having a bowel movement daily. The client should not stop taking the medication for any reason unless discussed with the physician.
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The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?
- A. Progressive tissue damage without any verifiable etiology
- B. Absence of a triggering event
- C. Profound fatigue with no identifiable cause
- D. Affects only older adults and infants less than 3 months
Correct Answer: A
Rationale: Diseases are considered autoimmune disorders and are characterized by unrelenting, progressive tissue damage without any verifiable etiology. In many autoimmune disorders, there tends to be a triggering event, such as an infection, trauma, or introduction of a drug that integrates itself into the membranes of the host's cells. Although older adults face a greater risk of developing autoimmune disorders, persons belonging to any age-group can be affected. Chronic fatigue syndrome is primarily characterized by profound fatigue with no identifiable cause, and this is not a characteristic of autoimmune disorders.
A client is taking oral corticosteroids after having an exacerbation of asthma. What should the nurse be sure to include when instructing the client how to take the medication?
- A. The medication will cause weight loss.
- B. The medication will cause drowsiness so do not drive.
- C. Take the medication on an empty stomach to increase absorption.
- D. Take the medication in the morning with food.
Correct Answer: D
Rationale: Taking the oral corticosteroids in the morning with food will help reduce the gastrointestinal upset that may be experienced. The medication causes weight gain not weight loss, does not cause drowsiness, and should not be taken on an empty stomach.
A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve nasal congestion caused by seasonal allergies. What instructions should the nurse provide to the client to avoid complications?
- A. Report white patches in the mouth because the medication can cause a fungal infection.
- B. Do not overuse the medication as rebound congestion can occur.
- C. Taper the dose when discontinuing the medication.
- D. Do not operate machinery or drive while using the medication.
Correct Answer: B
Rationale: Overusing oxymetazoline nasal spray can cause rebound congestion. The medication does not cause fungal infection. Corticosteroids should be tapered, but it is not necessary to taper oxymetazoline. Oxymetazoline does not cause sleepiness so the client can operate machinery or drive.
The nurse is collecting data from a client with the autoimmune disorder endocarditis. What does the nurse recognize as symptom of an acute exacerbation?
- A. Temperature of 100.9?°F
- B. Respiratory rate of 20 breaths/minute
- C. Constipation
- D. Nausea
Correct Answer: A
Rationale: Periods of acute flare-ups (known as exacerbations) are completely unpredictable. During acute exacerbations, clients often experience a low-grade fever, malaise, or fatigue. They also may lose weight. A respiratory rate of 20 breaths/minute is within normal range. Constipation and nausea are not characteristic of a flare-up of endocarditis.
A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?
- A. If the client experiences nausea, omit the dose.
- B. The client should be alert for joint aches.
- C. This medication is commonly used for many inflammatory reactions and is relatively safe.
- D. Be alert for signs and symptoms of infection and report them immediately to the physician.
Correct Answer: D
Rationale: Instruct the client about signs and symptoms of and the increased risk for infection. Instruct the client to report signs and symptoms of infection immediately to the physician. Early treatment promotes a shorter duration of illness and reduced complication. Tell the client to avoid high-risk activities, such as being in crowds, during periods of immunosuppression. The client should not omit a dose if nausea is experienced but instead may take the medication with food. There are many side effects and required laboratory work to detect the side effects from immunosuppressive therapy. Joint aches are vague symptoms and are not a priority for reporting purposes.