Pharmacological and Parenteral Therapies Q 6

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You are caring for a patient with recurrent glioblastoma who is receiving dexamethasone (Decadron) 4 mg IV every 6 hours to relieve symptoms of right arm weakness and headache. Which assessment information concerns you the most?

  

     A. The patient does not recognize family members.

     B. The blood glucose level is 234 mg/dL.

     C. The patient complains of a continued headache.

     D. The daily weight has increased 1 kg.

    

    

Correct Answer: A. The patient does not recognize family members.

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The inability to recognize a family member is a new neurologic deficit for this patient, and indicates a possible increase in intracranial pressure (ICP). This change should be communicated to the physician immediately so that treatment can be initiated.

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Option B: Increased blood glucose levels is an expected side effect but not an emergency.

Option C: The continued headache also indicates that the ICP may be elevated, but it is not a new problem.

Option D: The weight gain is a common adverse effect of dexamethasone that may require treatment, but is not an emergency.

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