Ch. 44 Corticosteroid Therapy

Which statement accurately describes the glucocorticoid that is secreted from the adrenal cortex along with its effect in the body?

Cortisol, which impacts carbohydrate metabolism

Which corticosteroid is the treatment of choice for a patient with Addison disease

Fludrocortisone

A patient has been newly prescribed theophylline for asthma management. In addition to theophylline, the patient is also receiving prednisone. Which drug interaction between theophylline and prednisone does a nurse anticipate for this patient?

Prednisone will interact with theophylline, causing decreased effects of prednisone.

A patient has been prescribed prednisone 10 mg PO daily for worsening systemic lupus erythematous (SLE). The patient is also on hydroxychloroquine (for SLE) and warfarin (for venous thromboembolism). Which effect does the nurse anticipate will occur if prednisone is administered to this patient?

The prednisone will interact with warfarin, increasing the effects of warfarin.

Which parameters will a nurse ensure have been assessed before administering prednisone to a patient newly diagnosed with systemic lupus erythematous?

Weight sodium glucose bp presence of preexisting edema

Glucocorticoids

affect metabolism of carbohydrates, fats, and proteins

Mineralocorticoids

are responsible for the regulation of electrolytes, or mineral salts, in the body

Inhaled corticosteroids

are used in the management of respiratory diseases such as asthma.

Prednisone

is the most commonly prescribed oral corticosteroid,

A nurse instructs a patient with rheumatoid arthritis who was prescribed prednisone 20 mg PO daily. Which statements by the patient indicate that patient teaching was effective?

-"I will make sure to have a diet rich in vitamin D and calcium to reduce my risk for osteoporosis." -"I will make sure to take the prednisone with food to avoid an upset stomach." -"I may experience side effects and adverse effects such as insomnia, weight gain, and mood swings."

Which patients does a nurse determine cannot safely receive prednisone?

-A 33-year-old patient with active tuberculosis -A 78-year-old patient with cataracts

Which categories can be used for classifying glucocorticoids?

-Duration of action -Route of administration -Natural versus synthetic analog -Potential for sodium and water retention

Which statements regarding the pharmacokinetics of glucocorticoids are accurate?

-Rate of absorption varies depending on the glucocorticoid and route of administration. -Rapid absorption occurs when sodium phosphate and sodium succinate esters are given intramuscularly. -Glucocorticoids undergo hepatic metabolism to produce inactive metabolites.

Which statements accurately describe the actions glucocorticoids exert in the inflammatory process?

-Stimulation of erythroid cells -Reduction of interleukin-1 release from white blood cells -Promotion of protein metabolism, glycogen production, and fat redistribution -Stabilization of lysosomal cell membranes to reduce capillary permeability and leukocyte migration

Which side/adverse effects and/or laboratory results would a nurse monitor for while a patient is receiving fludrocortisone?

-Swelling in the extremities -Increased blood sugars -Hypertension -Decreased bone mineral density

Which parameters would be assessed in a patient who has been prescribed prednisone?

-Vital signs -Glucose levels -Potassium levels -Presence of preexisting edema -Skin color, turgor, and temperature

A nurse is caring for a patient who is receiving 4 mg of intravenous methylprednisolone. What equivalent dose of prednisone in milligrams would this patient receive at discharge?

5 mg

Which patient cannot safely receive therapy with fludrocortisone?

A 40-year-old patient with pulmonary aspergillosis

Which statement about fludrocortisone is accurate?

Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity.

Which statement accurately describes corticosteroids?

Glucocorticoids affect carbohydrate metabolism, and mineralocorticoids regulate electrolytes.

Which drugs are anticipated to interact with prednisone?

HCTZ Metformin

A nurse is providing care to a patient with chronic kidney disease (CKD) who has been prescribed methylprednisolone. Which statement describes the appropriate nursing action for this patient and the rationale for this action?

The nurse should monitor for side effects because methylprednisolone is renally excreted.

Topical corticosteroids

are often used to treat skin, eye, and ear inflammatory conditions.

methylprednisolone

most common injectable corticosteroid

Intranasal corticosteroids

useful in managing allergic rhinitis.