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 Aldosterone, which impacts carbohydrate metabolism Cortisol, which maintains sodium levels and blood pressure Aldosterone, which maintains sodium levels and blood pressure
Cortisol, which impacts carbohydrate metabolism
Which corticosteroid is the treatment of choice for a patient with Addison disease? Betamethasone Fludrocortisone Prednisone Triamcinolone
Fludrocortisone
Which parameters will a nurse ensure have been assessed before administering prednisone to a patient newly diagnosed with systemic lupus erythematous? Weight Sodium level Glucose level Blood pressure Liver function tests Presence of preexisting edema
Weight Sodium level Glucose level Blood pressure Presence of preexisting edema
Which drugs currently taken by Mrs. Gabriel are anticipated to interact with prednisone? Atenolol Atorvastatin Enalapril HCTZ Metformin
HCTZ Metformin
Which patient cannot safely receive therapy with fludrocortisone? A 40-year-old patient with pulmonary aspergillosis A 52-year-old patient with type 2 diabetes A 60-year-old patient with gastroesophageal reflux disease A 70-year-old patient with glaucoma
A 40-year-old patient with pulmonary aspergillosis
Which parameters would be assessed in a patient who has been prescribed prednisone? Select all that apply. Vital signs Glucose levels Potassium levels Testosterone levels Presence of preexisting edema Skin color, turgor, and temperature
Vital signs Glucose levels Potassium levels Presence of preexisting edema Skin color, turgor, and temperature
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? Select all that apply. "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." "If my rheumatoid arthritis symptoms do not improve or get worse, I can take an extra dose of prednisone." "If side effects are bothering me, I will stop taking the prednisone and follow up with my physician later."
"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 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 are minimally protein bound. Glucocorticoids undergo hepatic metabolism to produce inactive metabolites. Glucocorticoids undergo biliary excretion.
-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
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 patients does a nurse determine cannot safely receive prednisone? A 33-year-old patient with active tuberculosis A 48-year-old patient with hypothyroidism A 55-year-old patient with type 2 diabetes A 59-year-old patient with dyslipidemia A 61-year-old patient with benign prostatic hyperplasia A 78-year-old patient with cataracts
A 33-year-old patient with active tuberculosis A 78-year-old patient with cataracts
Which categories can be used for classifying glucocorticoids? Select all that apply. Onset of action Duration of action Route of administration Natural versus synthetic analog Potential for sodium and water retention
Duration of action Route of administration Natural versus synthetic analog Potential for sodium and water retention
Which statement about fludrocortisone is accurate? Fludrocortisone is a glucocorticoid that is used in the management of inflammatory conditions such as rheumatoid arthritis. Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity. The anticipated onset of action of fludrocortisone is 1 to 2 hours. When given orally, it is minimally protein bound.
Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity. -Fludrocortisone possesses potent mineralocorticoid activity but also has significant glucocorticoid activity
Which statement accurately describes corticosteroids? The adrenal medulla secretes corticosteroids. There are two types of corticosteroids - epinephrine and norepinephrine. Glucocorticoids affect carbohydrate metabolism, and mineralocorticoids regulate electrolytes. Corticosteroid levels are regulated by the hypothalamic-pituitary-adrenal axis with use of a positive feedback mechanism
Glucocorticoids affect carbohydrate metabolism, and mineralocorticoids regulate electrolytes.
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 increased effects of prednisone. Prednisone will interact with theophylline, causing decreased effects of prednisone. Prednisone will interact with theophylline, causing increased effects of theophylline. Prednisone will interact with theophylline, causing decreased effects of theophylline.
Prednisone will interact with theophylline, causing decreased effects of prednisone.
Which statements accurately describe the actions glucocorticoids exert in the inflammatory process? Stimulation of erythroid cells Maintenance of sodium levels in the blood 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
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? Select all that apply. Symptoms of Cushing syndrome Swelling in the extremities Increased blood sugars Increased potassium levels Hypertension Decreased bone mineral density
Swelling in the extremities Increased blood sugars Hypertension Decreased bone mineral density
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 administer methylprednisolone because there are no concerns about this drug. The nurse should monitor for side effects because methylprednisolone is renally excreted. The nurse should monitor for side effects because methylprednisolone undergoes biliary excretion. The nurse should call the health care provider because the presence of CKD is a contraindication to treatment with methylprednisolone
The nurse should monitor for side effects because methylprednisolone is renally excreted. -This patient can cautiously receive methylprednisolone; however, the patient should be monitored for the emergence of side effects from the glucocorticoid because the drug undergoes renal excretion.
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. The prednisone will interact with warfarin, decreasing the effects of warfarin. The prednisone will interact with hydroxychloroquine, increasing the effects of hydroxychloroquine. The prednisone will interact with hydroxychloroquine, decreasing the effects of hydroxychloroquine.
The prednisone will interact with warfarin, increasing the effects of warfarin. -When prednisone is given with warfarin, it will likely increase the effects of warfarin, increasing the risk for bleeding in this patient. The patient's warfarin will need to be monitored more closely.
