Adjuvant Analgesics
Adjuvant Analgesics ( 5 Questions)
A nurse is reviewing the medication history of a client who has chronic pain and is prescribed dexamethasone as an adjuvant analgesic.
Which of the following statements by the client should alert the nurse to a possible adverse effect of this medication?
This statement by the client should alert the nurse to a possible adverse effect of dexamethasone, which is hyperglycemia. Dexamethasone is a steroid medication that has analgesic, antiemetic, and anti-inflammatory properties, but it can also increase blood glucose levels by stimulating gluconeogenesis and reducing insulin sensitivity. The nurse should monitor the client’s blood glucose levels and report any signs of hyperglycemia, such as polydipsia, polyphagia, and polyuria.
Insomnia is a common side effect of dexamethasone, but not a serious adverse effect. The nurse should advise the client to take dexamethasone in the morning to reduce the risk of insomnia and to avoid caffeine and alcohol before bedtime.
Tingling and numbness in the feet are not related to dexamethasone use. They could indicate peripheral neuropathy, which could have other causes such as diabetes, vitamin B12 deficiency, or nerve compression. The nurse should assess the client’s feet for sensation, circulation, and skin integrity and refer the client to a neurologist if needed.
Dexamethasone, but not a serious adverse effect. Dexamethasone can cause skin thinning and fragility, which can lead to easy bruising and delayed wound healing. The nurse should instruct the client to avoid trauma to the skin and to apply pressure to any bleeding sites. Normal ranges for blood glucose are 70-110 mg/dL (3.9-6.1 mmol/L) for fasting and <140 mg/dL (<7.8 mmol/L) for postprandial.
This statement by the client should alert the nurse to a possible adverse effect of dexamethasone, which is hyperglycemia. Dexamethasone is a steroid medication that has analgesic, antiemetic, and anti-inflammatory properties, but it can also increase blood glucose levels by stimulating gluconeogenesis and reducing insulin sensitivity. The nurse should monitor the client’s blood glucose levels and report any signs of hyperglycemia, such as polydipsia, polyphagia, and polyuria.
Choice B is wrong because insomnia is a common side effect of dexamethasone, but not a serious adverse effect. The nurse should advise the client to take dexamethasone in the morning to reduce the risk of insomnia and to avoid caffeine and alcohol before bedtime.
Choice C is wrong because tingling and numbness in the feet are not related to dexamethasone use. They could indicate peripheral neuropathy, which could have other causes such as diabetes, vitamin B12 deficiency, or nerve compression. The nurse should assess the client’s feet for sensation, circulation, and skin integrity and refer the client to a neurologist if needed.
Choice D is wrong because bruising on the arms and legs is also a common side effect of dexamethasone, but not a serious adverse effect. Dexamethasone can cause skin thinning and fragility, which can lead to easy bruising and delayed wound healing. The nurse should instruct the client to avoid trauma to the skin and to apply pressure to any bleeding sites. Normal ranges for blood glucose are 70-110 mg/dL (3.9-6.1 mmol/L) for fasting and <140 mg/dL (<7.8 mmol/L) for postprandial.