A client with type 2 diabetes begins long-term prednisone therapy for an inflammatory disorder. Which monitoring instruction is most important for the nurse to reinforce?
1Stop prednisone whenever the blood glucose rises above the usual target range.
2Check blood pressure monthly because glucose and infection risk are unaffected.
3Limit monitoring to annual eye examinations unless the prednisone dose is doubled.
4Check glucose as prescribed and promptly report fever, sore throat, or poor wound healing.✓ Correct answer
Explanation
Prednisone can worsen hyperglycemia and suppress immune responses, increasing infection risk and sometimes masking infection cues. A client with diabetes needs prescribed glucose surveillance and prompt reporting of possible infection rather than independently stopping glucocorticoid therapy.
Quick answer Monitor glucose and infection cues together.
Why this is correct Systemic prednisone can raise blood glucose and reduce immune defenses. Fever, sore throat, or poor wound healing may require prompt evaluation, while glucose surveillance helps detect worsening diabetic control.
Easy analogy or mental picture Prednisone can turn up the glucose dial while turning down the infection alarm.
NCLEX decision rule For chronic glucocorticoid therapy, monitor predictable metabolic and immune adverse effects and avoid abrupt self-discontinuation.
Why the other choices are wrong Stopping prednisone independently can be unsafe, blood pressure alone misses major risks, and annual eye care does not replace ongoing metabolic and infection surveillance.
References
1DailyMed: Prednisone tabletsHyperglycemia, immunosuppression, and infection warnings