Chapter 17

A client prescribed corticosteroids following a liver transplant asks if it will be necessary to take this medication indefinitely. How should the nurse respond?

"Daily antirejection drug therapy will continue for as long as your transplanted liver is in place."

A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction the nurse provide the client's family about this drug?

"Don't stop this medication suddenly; you will have to taper dosage gradually."

A nurse is caring for a client who is receiving a corticosteroid for arthritic pain. Which statement made by the client would raise concern about medication dosage revision?

"I recently lost my health care coverage and need to look for another job."

The nurse just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. Which statement indicates the client requires further instruction?

"I will start this medication as soon as I am feeling ill or tired."

The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?

"Take it first thing in the morning."

A child is to receive a topical corticosteroid agent. Which statement by the parents indicates a need for additional teaching?

"We need to cover the area snugly with plastic wrap to prevent scratching."

A group of students are reviewing the contraindications for glucocorticoid therapy. The students demonstrate understanding when they identify which condition?

Acute infection

What is a strategy to minimize HPA suppression and risks of acute adrenal insufficiency?

Administering a systemic corticosteroid during high-stress situations in clients on long-term systemic therapy

What is the most prevalent mineralocorticoid that regulates fluid balance?

Aldosterone

The nurse is caring for a client who has been diagnosed with cerebral edema caused by trauma. Which medication should the nurse be prepared to administer?

Dexamethasone

After teaching a group of students about mineralocorticoids, the instructor determines that the teaching was successful when they state which agent as an example?

Fludrocortisone

A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this client should prioritize which potential nursing diagnoses in the organization of the client's care?

Fluid volume excess

The nurse is monitoring a child who has been receiving long-term therapy with systemic corticosteroids. Which would be most important for the nurse to assess?

Growth pattern

The nurse has just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. What statement indicates the client requires further instruction?

I will start this medication when I am feeling ill or tired.

You are talking to your class of nursing students about the adverse effects of corticosteroid therapy. What dietary change would you tell the students may help prevent osteoporosis related to long-term corticosteroid administration?

Increasing vitamin D intake

The nurse is caring for an 84-year-old client with diabetes who is receiving hydrocortisone 40 mg daily PO for treatment of an arthritic flare-up. When writing a plan of care for this client, which nursing intervention would be most appropriate?

Monitoring blood glucose levels frequently

A client with asthma has been prescribed an inhaled corticosteroid. When providing client education related to correct use of the inhaler, what statement would the nurse include?

Rinse your mouth completely after using the inhaler.

A 65-year-old client who has been on long-term corticosteroid therapy is admitted to the hospital and will need an IV inserted. What adverse effect of corticosteroid may negatively affect this procedure?

Thinning of the skin

A nurse tells a patient to take a prescribed glucocorticoid in the morning based on the understanding that:

This time mimics the normal peak diurnal concentration levels.

Which finding should alert the nurse to a potential Cushing's syndrome manifestation presented by a client prescribed long-term corticosteroid therapy?

buffalo hump

A nurse is providing discharge instructions to a client who will be taking fludrocortisone at home. The nurse will encourage the client to eat a diet that is:

low in sodium, high in potassium.

The nursing instructor is discussing short-term versus long-term corticoid steroid therapy with the nursing students. What would be the most appropriate teaching for a client on long-term corticosteroid therapy?

Taper doses when discontinuing drug

A client prescribed alternate-day administration of corticosteroids asks the nurse why the drug isn't administered every day. How would the nurse describe the benefit of alternate-day therapy (ADT)?

"It minimizes suppression of adrenal function."

When providing client education relative to an inhaled glucocorticoid, the nurse should include which instruction to prevent a common side effect of the medication?

"Rinse your mouth completely after using the inhaler."

Which would a nurse expect to assess in a patient with an adrenocortical hormone deficiency? (Select all that apply.)

Confusion Hyperkalemia Hyponatremia

A female client asks the nurse why her 4-year old son is not receiving corticosteroids. The client read in an article that they are more effective to prevent transplant rejection than the medication that is currently prescribed. What is the appropriate response by the nurse?

Corticosteroids impair growth in children.

Which corticosteroid would a nurse identify as having the longest acting glucocorticoid effects?

Dexamethasone

A male client is diagnosed with Addison disease. What daily medication would the nurse expect to be administered?

Prednisone

When monitoring a client who is receiving mineralocorticoid therapy, which assessment finding would be most important for the nurse to report?

Shortness of breath

The nurse is working in a home care setting. A female client is prescribed oral corticosteroids by her health care provider secondary to a diagnosis of Addison disease. What is the nurse's responsibility in this situation?

Supervising and monitoring the administration of the drug

The home health nurse is making a plan of care for a new client who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone?

Take with a meal

A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid:

adrenal insufficiency.

The nurse anticipates an order for a glucocorticoid when caring for a client with what condition?

arthritis

A nurse is preparing medication information for the spouse of a client diagnosed with cerebral edema. Which medication should the nurse include in this information?

dexamethasone

A nurse is caring for a client with adrenocortical deficiency. The health care provider has prescribed a fludrocortisone drug to the client. Which adverse reaction should the nurse monitor for in the client?

edema

A client has been prescribed a corticosteroid for the treatment of chronic adrenocortical insufficiency. The nurse's instructions for administration should include taking the medication under what condition?

in the morning.

When caring for a client receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

infection

A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?

potassium