Pharmacology Ch. 33 Adrenal Drugs

The nurse teaches a patient receiving long-term corticosteroid drug therapy about the dosage regimen. Which response by the patient indicates the need for further teaching?

"I will stop taking this medication if I have any adverse effects."

The nurse is caring for a patient who has recently undergone an adrenalectomy. During preparation for discharge, the nurse teaches the patient's family members about care to be given at home. Which instruction would the nurse include in the teaching?

"Immediately report any wound infection."

The nurse is teaching a patient who has been prescribed a daily oral dose of prednisone about the medication regimen. Which instructions will the nurse provide the patient to ensure safe administration? Select all that apply.

"Take each dose with milk or food." "Take the medication early morning."

A nursing student is asked to administer prednisone to a patient. Which statement by the nursing student reflects effective planning?

"The medication should be administered with food to diminish the risk of gastric irritation."

A nursing student is caring for an elderly patient who has Cushing's syndrome. The nursing instructor asks the student about the characteristics that can be observed in patients with Cushing's syndrome. Which response by the student is correct?

"The patient has muscle weakness because of increased carbohydrate metabolism."

The nurse is caring for several patients who are receiving glucocorticoid therapy. Which patient would the nurse assess first?

A patient with uncontrolled diabetes mellitus

A patient is undergoing glucocorticoid therapy. Which medication would the nurse administer to the patient for mild pain management?

Acetaminophen

Which condition would a nurse expect in a patient who abruptly withdraws from a glucocorticoid medication?

Addison's disease

The nurse is caring for a patient who has undergone nasal surgery for the removal of polyps. Which treatment strategy would the nurse expect to be used to prevent the recurrence of polyps?

Administering glucocorticoids to the patient

Which corticosteroid drug is safe to use during pregnancy?

Betamethasone

The nurse is caring for a patient who has Addison's disease who takes a loop diuretic medication. Which other medications would the nurse likely find in the patient's prescription to provide effective treatment? Select all that apply.

Calcium supplements Potassium supplements

Which condition is a contraindication to the use of fludrocortisone?

Candidiasis

Which conditions can be treated with glucocorticoid drugs? Select all that apply.

Cerebral edema Systemic lupus erythematous Chronic obstructive pulmonary disease

The nurse is caring for a patient with an adrenal tumor. The health care provider has prescribed an antiadrenal drug to the patient. Which therapeutic responses will the nurse assess in this patient? Select all that apply.

Decrease in the tumor size Decrease in Cushing's syndrome symptoms

A patient who has been receiving long-term corticosteroid therapy has undergone surgery for the treatment of an abdominal hernia. Which potential effect of this therapy would the nurse expect to have the most impact on the patient's recovery?

Delayed wound healing

A patient is being treated for secondary adrenocortical insufficiency. If the patient's adrenal glands are still intact, which medication used in the treatment of primary adrenocortical insufficiency would the nurse avoid?

Fludrocortisone

A patient has been prescribed a beclomethasone inhaler. When teaching the patient about the use of inhalers, the nurse instructs the patient to rinse the mouth with warm water after using the inhaler. Which side effect is the nurse trying to prevent?

Fungal infection

The nurse is caring for a patient with Addison's disease who has been prescribed corticosteroids. Prior to administering the medication, which conditions would the nurse assess for in the patient? Select all that apply.

Glaucoma Septicemia Diabetes mellitus

Which information would the nurse obtain prior to giving glucocorticoids to a 10-year-old patient?

Height and weight

Which medication would the nurse expect to administer to a patient with adrenal insufficiency if the patient is unable to produce it endogenously?

Hydrocortisone

Upon reviewing the laboratory reports of a patient with hypoglycemia, the nurse expects that the patient would be prescribed a combination of fludrocortisone and prednisone. Which findings did the nurse observe in the patient's laboratory reports to suggest such a conclusion?

Hyperkalemia

Which symptom would the nurse assess for in a patient taking prednisone that suggests adrenal crisis?

Hypotension

The nurse is caring for a patient who has hypertension and is on continuous corticosteroid therapy to treat adrenal insufficiency. The electrocardiograph shows a steady slowing of the patient's heart beat. The patient's blood pressure is 140/96 mm Hg. Which medication may contribute to the patient's symptoms?

Loop diuretic

The nurse is assessing an older adult who has a dermatologic disorder and has been prescribed methylprednisolone. During the assessment, the nurse learns that the patient has myasthenia gravis and is taking anticholinesterase medications. Which adverse effect would the nurse expect if methylprednisolone is administered to this patient?

Muscle weakness

The nurse is caring for a patient who has systemic lupus erythematosus who has been taking prednisone for several years. Which change in the patient will the nurse assess to detect complications from long-term therapy?

Presence of belly fat

A patient with Addison's disease is prescribed corticosteroids. During the follow-up visit the nurse finds that the patient is taking oral contraceptives and has severe insomnia and osteoporosis. Which is a possible reason for insomnia and osteoporosis in the patient?

Presence of corticosteroids in the blood for longer lengths of time

The nurse is caring for a patient with Addison's disease who has been prescribed a combination of oral prednisone and fludrocortisone. After a few days the patient reports severe gastrointestinal upset. Which treatment does the nurse expect to be prescribed for the patient?

Proton pump inhibitor medication

What role does the release of cortisol play in the stress response?

Provides more fuel for cells

The nurse administers fludrocortisone to a patient who has acute primary adrenocortical insufficiency. Which adverse effect of the therapy is a priority for the nurse to prevent?

Pulmonary edema

A patient with diabetes mellitus has recently undergone pancreas transplantation. According to the prescription, the nurse administers a long-acting depot formulation of methylprednisolone. The next day, the patient's blood glucose concentration and blood pressure are higher than the normal levels. Which factor may be the reason for the high blood glucose concentration?

Release of excess drug from the depot formulation

A patient is receiving dexamethasone to prevent cerebral edema caused by a motor vehicle accident. Which nursing intervention will help to prevent complications of the pharmacotherapy?

Requesting a prescription for a proton pump inhibitor

The nurse is performing a follow-up assessment of a patient who is being treated with glucocorticoids for an exacerbation of chronic obstructive pulmonary disease (COPD). Which assessment findings indicate that the treatment is effective? Select all that apply.

Respiratory rate of 16 breaths/min Oxygen saturation of 95% Random blood glucose concentration of 150 mg/dL

Which would the nurse include in patient education on the side effects of inhaled glucocorticoids?

Rinse out mouth after use.

When assessing for potential side effects of fludrocortisone, which assessment is a priority for the nurse to monitor?

Serum potassium levels for hypokalemia

Which statement about glucocorticoids is correct?

They influence carbohydrate, fat, and protein metabolism.

A patient is about to receive steroid therapy. Which disorder would contraindicate administration of the medication?

Uncontrolled diabetes mellitus

After a patient assessment, the nurse concludes that the patient has undersecretion of adrenocortical hormones. Which finding would cause the nurse to arrive at this conclusion?

Unexplained weight loss

A patient with a history of asthma frequently receives prednisone for acute bronchitis. Which adverse effects would the nurse anticipate that the patient may experience with continuous use of the therapy? Select all that apply.

Weight gain Personality changes Loss of muscle bulk Loss of bone density