Chapter 60: Drugs for Disorders of Adrenal Cortex

The nurse is caring for a patient who has Addison's disease. The primary healthcare provider prescribes fludrocortisone [Florinef]. Which adverse effect should the nurse monitor in this patient?

Hypokalemia

The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid-afternoon. Which statement by the nurse is correct?

You can take 16 mg in the morning and 8 mg in the afternoon

The nurse administering hydrocortisone to a patient recognizes which statement(s) as true regarding the medication? Select all that apply.

-It is a synthetic steroid identical to cortisol -It has glucocorticoid and mineralocorticoid actions -It is a preferred drug for adrenocortical insufficiency

When assessing a patient who has Cushing's syndrome, the nurse recognizes which characteristics as clinical manifestations of this disorder? Select all that apply.

-Moon face -Glycosuria -Mood swings -Osteoporosis

The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many milliliters will the nurse administer? Record your answer using two decimal places. Use a leading zero if applicable. _____ mL

0.50

The patient is having an overnight dexamethasone suppression test performed to diagnose Cushing's syndrome. A nurse administers dexamethasone [Decadron] 1 mg, at 11:00 PM. During shift change report, the nurse should instruct the oncoming nurse to draw blood for which test at 8:00 AM?

Cortisol

The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority patient problem?

Deficient fluid volume

A nurse is developing a plan of care for a patient with Addison's disease who is taking hydrocortisone [Cortef]. Which outcome is of the highest priority for this patient's care plan?

During times of stress, the patient increases the glucocorticoid dose

A patient who has Cushing's syndrome is taking ketoconazole [Nizoral] as an adjunct treatment to brain radiation. A nurse should expect the patient to have which therapeutic response?

Enhanced radiation effect to the brain

A patient is taking fludrocortisone [Florinef]. A nurse should recognize that which symptom, if reported by the patient, indicates the patient is experiencing a life-threatening electrolyte imbalance caused by fludrocortisone therapy?

Muscle weakness

The nurse is teaching the patient about oral steroid therapy for chronic adrenal insufficiency. Which statement by the patient indicates a need for further teaching?

When I am traveling for work I will take lower doses