Adrenal Cortex Drug Therapy

Question 2 of 4 Fludrocortisone is sometimes used with hydrocortisone as therapy for Addison's disease. Which rationale for the addition of fludrocortisone is accurate? Manage fluid and electrolyte balance Facilitate elimination of excessive fluid Promote immunosuppression Regulate the body's glucose balance

Manage fluid and electrolyte balance Fludrocortisone, a mineralocorticoid, is used to maintain fluid and electrolyte balance and raise blood pressure primarily through retention of sodium.

Question 1 of 5 Which statement made by Ms. Sanders indicates a good understanding of the adverse effects of hydrocortisone and fludrocortisone therapy? "As my condition improves, I can decrease my dose." "These medicines have very few side effects when used as directed." "I must have my blood checked regularly to assess for side effects of my medication." "I must have my cholesterol checked regularly to assess for side effects of my medication."

"I must have my blood checked regularly to assess for side effects of my medication." Electrolytes must be evaluated regularly to assess for adverse effects from glucocorticoid therapy. Electrolyte imbalance can occur, leading to heart failure and other cardiovascular side effects.

Question 4 of 5 Which statement by the patient indicates an understanding of taking hydrocortisone as replacement therapy for Addison's disease? "I must take this medication on a daily basis as instructed." "This medication is intended to cure my Addison's disease over time. "My health care provider will taper my dose over 1 to 2 weeks before stopping it completely." "My health care provider will allow me to stop taking the medicine as soon as I feel better."

"I must take this medication on a daily basis as instructed." Replacement therapy is intended to be a long-term intervention for Addison's disease.

Question 7 of 9 A patient with Addison's disease is upset about weight gain and wants to stop taking hydrocortisone and fludrocortisone. Which response would the nurse make? "Weight gain is a side effect of the medication. You may need to seek counseling." "It is fine to stop taking your medicine as long as you carefully monitor your glucose levels." "If you stop taking the medications, you may have severe side effects." "Begin to taper your dosage and check with your health care provider about an exercise program that you can begin."

"If you stop taking the medications, you may have severe side effects." Abruptly stopping the medication, especially after long-term use in a chronic disease, can cause severe side effects including nausea, fever, sudden severe joint pain, fatigue, and orthostatic hypotension.

Question 5 of 5 A patient with type 1 diabetes has a new prescription for hydrocortisone. Which education should the nurse provide to this patient? "If you have a sudden increase in weight, try to limit your fluids for a couple of days." "Contact the health care provider if you are going to have surgery so your medications can be withheld." "If your baseline bone density test was normal, then you do not have to be concerned about osteoporosis related to hydrocortisone therapy."

"The insulin drug dosage to manage your diabetes may need to be increased since hydrocortisone can raise your blood glucose levels." Hyperglycemia is a common side effect of adrenal cortex medications, like hydrocortisone, even when a patient is already on insulin.

Question 3 of 4 Which action describes how fludrocortisone raises the blood pressure in persons with Addison's disease? Acts as a pressor on blood vessels Increases sodium elimination Increases thirst and water intake Decrease cortisol levels in the blood

Acts as a pressor on blood vessels Fludrocortisone acts directly as a pressor on the blood vessels and contributes to sodium retention, thus elevating the blood pressure.

Question 1 of 4 Which description of the therapeutic use of hydrocortisone in Addison's disease is accurate? As an antiinflammatory agent To modulate allergic response As replacement cortisol therapy To promote immunosuppression

As replacement cortisol therapy Hydrocortisone is used in Addison's disease as replacement therapy for cortisol deficiency.

Question 4 of 4 Which phrase describes the action of metyrapone drug therapy in a patient with Cushing's disease? Regulates and normalizes blood glucose levels Suppresses adrenocorticotropic hormone (ACTH) production to lower cortisol levels Treats headaches associated with Cushing's disease Blocks process of cholesterol conversion to cortisol

Blocks process of cholesterol conversion to cortisol Metyrapone, a steroidogenesis inhibitor, blocks one or more steps in the conversion of cholesterol to cortisol. Through this process, cortisol levels are controlled in Cushing's disease on a temporary basis.

Question 1 of 9 Hydrocortisone is a synthetic steroid with a structure identical to which hormone? Insulin Cortisol Androgens Mineralocorticoids

Cortisol Cortisol is a principal glucocorticoid produced by the adrenal cortex. It has a structure identical to hydrocortisone, a synthetic steroid.

Question 8 of 9 Which foods would the nurse advise patients on long-term fludrocortisone for Addison's disease to include in their diet? Foods rich in potassium Foods high in vitamin C Foods that are sugar-free Foods low in calcium and vitamin D

Foods rich in potassium Persons taking fludrocortisone retain sodium and lose potassium. As a result, food high in potassium should be encouraged. These include fruits, vegetables (potatoes), meats, and nuts.

Question 4 of 9 When teaching a patient about the most common side effects of hydrocortisone, which information would the nurse include? Select all that apply. Heartburn or indigestion Insomnia and mood swings Increased bone pain Delayed wound healing Nasal congestion and cough Increased bruising

Heartburn or indigestion Insomnia and mood swings Delayed wound healing

Question 3 of 9 A patient is admitted to the emergency department with acute adrenal crisis. Which drug would the nurse anticipate administering? Fludrocortisone Pasireotide Hydrocortisone Metyrapone

Hydrocortisone For acute adrenal crisis, hydrocortisone is the drug of choice. It replaces the adrenal hormone deficiency that occurs during adrenal crisis.

Question 2 of 5 Which changes in laboratory values can occur while taking fludrocortisone? Hypoglycemia Hyponatremia Hypokalemia Hypocalcemia

Hypokalemia Hypokalemia is likely to occur with fludrocortisone administration because this drug works to retain sodium and eliminate potassium.

Question 9 of 9 Hydrocortisone is prescribed to a patient newly diagnosed with Addison's disease. When reviewing current medications taken by the patient, the nurse is aware that hydrocortisone could increase the action of which drugs? Select all that apply. Ibuprofen, a nonsteroidal antiinflammatory drug, for pain Omeprazole, an H2 receptor antagonist Alendronate, a bisphosphonate, for osteoporosis Metformin, an antidiabetic drug Simvastatin, a statin or HMG CoA reductase inhibitor, for hyperlipidemia Furosemide, a loop diuretic

Ibuprofen, a nonsteroidal antiinflammatory drug, for pain Metformin, an antidiabetic drug Furosemide, a loop diuretic

Question 6 of 9 A female patient with Addison's disease has started taking fludrocortisone in addition to hydrocortisone. She calls the clinical nurse to report feet swelling and a headache. Which action should the nurse take? Reassure the patient that this is an expected response to drug. Encourage the patient to rest with feet elevated for about an hour. Instruct the patient to come to the clinic for further evaluation. Advise the patient to hold the drug and wait 24 hours before resuming.

Instruct the patient to come to the clinic for further evaluation. Swollen feet indicate fluid overload and further evaluation needs to be done.

Question 3 of 5 A patient taking hydrocortisone therapy reports muscle twitching and cramps. Which intervention would the nurse take? Obtain calcium level. Obtain potassium level. Assess for symptoms of withdrawal. Ask when drug was last taken.

Obtain calcium level. Muscle twitching and cramps are symptoms of hypocalcemia, a side effect of long-term cortisone therapy. A calcium level should be obtained.

Question 5 of 9 Which concerns would the nurse address when teaching patients about long-term hydrocortisone therapy for Addison's disease? Select all that apply. Potential infections Drug interactions Weekly blood draws Medication compliance Significant diet restrictions

Potential infections Drug interactions Medication compliance

Question 2 of 9 The nurse is administering pasiriotide to a patient with Cushing's disease secondary to a pituitary tumor. Which phrase describes the rationale for using this drug? To decrease inflammation before surgery To shrink the pituitary tumor To block production of adrenocorticotropic hormone (ACTH) To increase retention of sodium

To block production of adrenocorticotropic hormone (ACTH) Pasiriotide is prescribed to block ACTH production in persons with Cushing's syndrome secondary to a pituitary tumor.