A client with juvenile pilocytic astrocytoma who is receiving dexamethasone (Decadron) 4mg/IV every 6 hours to relieve symptoms of right arm weakness and headache. Which of the following assessments will concern the nurse most?
A. Blood glucose level of 280 mg/dl.
B. Daily weight gain of 0.5 kg.
C. Client no longer recognizes the family member.
D. Client still complains of headaches.
Correct Answer: D. Client still complains of headaches.
The inability to recognize family members is a new neurologic deficit for this client and indicates a possible increasing intracranial pressure (ICP).
Option A: Steroids promote gluconeogenesis or increased serum blood sugar levels.
Option B: Steroids such as dexamethasone can cause improvement in appetite and retention of fluid, hence weight gain may be expected.
Option D: The continuing headache indicates an increased ICP but is not a new problem.